Slight return...

It's back. The remission had a good run, but myeloma is a wily beast that changes its spots regularly.

There's an excellent chance of this being beaten down once again with perhaps the same protocol used in induction therapy: Velcade, Doxil and Dextamethasone. The induction therapy was stopped because it was working so well they achieved a remission, not because the therapy had stopped working.

I had written here that there was not a lot found. This was my mistake, I misunderstood what Richie had said. There is a pretty big concentration of mutant cells in the sample, (60%) although the fact that the M-Spike is only 1.0 leads the doctor to suspect he hit a pocket of mutant cell activity with the biopsy.

One fact which militates in favor of a rapid return to remission after treatment: Richie is in better physical shape now than when he first presented at City of Hope in late January 2007.

Keep thinking good thoughts, praying, or whatever for him. That always helps.

Yesterday: second dose of Melphalan. Today: cells returned

I failed to update yesterday because by the time I got home from Duarte it was 9:20pm and I was tired.

I visited Richie yesterday, and while the Melphalan was no picnic, he seemed to be in good spirits and well enough to take a little stroll through the wing of the hospital. Yes, he is allowed to get out of his room and walk around, and this is because of the unique design of Helford Clinical Research Hospital.

Normally sterile rooms are kept sterile one room at a time. The sterile room is approached from a two-door vestibule which serves as an "airlock." The patient is confined to that one room for all of their treatment. When Helford was constructed, it was designed from the ground up to have two floors with two sterile wings each. Each wing is entered from a double-door vestibule. The air beyond the second door is filtered, and anti-microbial surfaces are used wherever possible.

While in the patient room, the visitor needs to "wash up, glove up, and mask up" in order to provide an added measure of safety while the patient's immune system rebuilds. While outside the room, but within the sterile wing, the patient "gloves up and masks up" to protect themselves. Visitors and nurses do not need to wear gloves and masks outside the room.

Richie is getting the stem cells today. Hopefully all is going well. I called him this morning and he was still waking up. Neither of us are good in the morning, and I'm sure the chemo doesn't help. I will update when I find out how he's doing.