Visit with Dr. Atanackovic March 13

Tuesday morning I received a phone call from Justin, my patient coordinator at the Huntsman BMT clinic, to tell me that Dr. Atanackovic had called in to say that he was under the weather and would not be coming in to the clinic that day.  I was asked whether I could come in at the same time on Thursday and had to think for a few minutes because I remembered that we had  some sort of engagement that day, but in a few moments it came to me that we were going to wish Daniel goodbye at a gathering at his parent's home that evening, so agreed to the change.

Emma went with me to the clinic and we arrived a minute or two before the appointed time of 2:00 PM a new to me nurses aide, Marie-Annette, soon took me in to a weight room for vitals and then took us to one of the examining rooms to wait for the doctor.  But Caitlin Skaggs also new to me, who identified herself as one of doctor Atananckovic's nurses (She told me his name is pronounced with a hard C in front of the K rather than a soft C as I had been expecting) came into the room with my medication schedule to be reviewed prior to his visit and then asked many questions about my health and any recent events that should be noted; I told her about my fall on January 30 and the x-rays the following Monday and about the continued ill effects.  Her interrogation lasted until just after 2:30 and the doctor soon appeared.

As soon as Dr. Atanckovic came in I told him about the January fall and the after effects and this information was a relief to him because of the PET scan results, which were disclosed later.  When he started talking I became somewhat concerned that he intended to terminate the maintenance program that I have been on, with some modifications, since December 2009.  He told us that the large myeloma clinics, and mentioned the Mayo clinic specifically, only keep their patients on a maintenance program for a maximum of two years and said that the patients get tired of the side effects that never seem to go away and essentially ask to terminate the maintenance.  We talked about the side effects that I experience and I told him that I only feel the neuropathy in my feet and fingers and these are much milder than those I felt when I was on Thalidomide, which was stopped in October 2010 by Dr. Tricot who substituted Cyclophosphamide for it, which I continued taking on the 1st and 15th days of each cycle until August 2012.  I do not recall what, if any, side effects that I experienced while taking that medication.  But I assured him that my body seems to have become accustomed to the meds. that I take now and I am quite comfortable with the maintenance program. He then said that we will continue it just as it has been for the immediate future and that he will not need to see me again for 6 months.

Caitlin then came back along with Jason Ward, the patient coordinator, to try to schedule an ongoing maintenance program.  I told them I like coming in at 10:00 AM on Mondays so we repaired to the office and learned that next Monday at 10:00 is available and I was then scheduled for that as my next visit.  The doctor has specified that the Myeloma markers will only be determined every 3 months instead of every month as they have been ever since the maintenance program started.  So they will only draw 2 or 3 vials of blood Monday and presumably 2 on the 3rd Monday and I will not have to wait for the blood work to be reported before getting the Velcade infusion on days 2 and 4; only on those days when blood is drawn. They gave me a packet of results from the tests of March 3 and when I read the report on the PET/SC scan after getting home I learned why Dr. Atanackovic had been concerned about what the scan had showed.  They reported having seen a cracked rib that had not been there previously and assorted other damage to the sternum and other ribs all indicating trauma.  And this explains to me why I continue to have pain in my right arm, but do not recognize pain in my chest.  All no doubt caused by the January fall.