January Update

Hello to Everyone again and sorry for the long interim since the last report.
As usual some things have remained the same and some have changed dramatically. I have been on chemo again since June for a mild relapse & and am taking 2 drugs – Revlimid (Thalidomide with Decadron pulses on 21 day cycles). That initially demonstrated improvement but my December testing showed more disease progression although still nothing like initially So Dr. Van Rhee has doubled the Revlimid & also I now take 9 days of Decadron pulses (20 mg/day)/month instead of four. I just started the new regimen on January 1st. Lets’ keep our fingers crossed. Plus there are other treatment options available short of further stem cell transplants which I hope would be far off in the future if needed.
I still feel well the vast majority of the time and only have scattered down days each month where I am tired and fatigued and those are all normal. I just stay home and do little or nothing on those days. I have been working partial clinical shifts most at the nearby hospital at Mansfield just helping out when I can and that has been a lot of fun. However now that we are into flu season again and the new drug regimen will likely cause immunosuppresion, I will likely reduce clinical time and potential exposures. I’ll be having weekly labs to watch the blood counts. I sure do not want to end up in the hospital again with pneumonia like I did last February.
So that is the myeloma news but the bigger news in the recent past in that I finally got my faulty prosthetic hip revised on November 29th in Little Rock. We decided to have it done there since all my records are there plus we know the system well which makes thing go so much smoother. The original hip was replaced April 18, 1995 – the day before the Oklahoma City bombing so I got reasonable life from it but with time the polyethylene liner progressively wore out causing repeated subluxations/dislocations which increased in frequency as my activity levels increased. I could feel it was not stable and had to be very careful even with simple walking and the least slip would put it out which resulted in some major embarrassments and near serious accidents – like going out in a hot 7-Eleven parking lot while changing a tire last summer, popping out while bending over to wash the lower parts of my truck, getting stuck while hooking up wires behind my TV and the biggest one was putting on Baby Oil at the pool from a standing position, inadvertently leaning too far forward, popping out of place then crashing head first into deck chairs hurting an ankle, a wrist, two fingers and my nose. That one was the crowing blow to say the least.
The surgery could not happen fast enough so 11-29-2007 was a welcomed day. I decided to have the procedure done under epidural anesthesia to avoid the addition complication associated with general anesthesia and it was a wise choice that I highly recommend. Aside from having difficulty placing the catheter due my narrowed, arthritic disc spaces, it went well and definitely was the coolest most surreal thing I have ever experienced. First I lost all sensation in both legs but could still freely move them then that went. They give you Fentanyl and Versed then titrate Propofol so you are kind of in and out and you can hear people talking and I was talking & joking with them at times. It was a blast. Towards the end of the procedure an arm was falling asleep because I was on my side and they had my shoulder extended so I asked anesthesia if he could put me down and he said “no problem” and the next thing I was done and being placed on the bed. The procedure took about 3 ½ hours (I figured 60-75 minutes – yea right) but there were a couple complications. First a tip of on of the instruments broke off behind the new pelvic apparatus in an area when they had grafted some cadaver bone. Even though it was in an innocuous position they still tried to retrieve it for over an hour. The only way it will ever be noticed is on X-ray. Then the much bigger deal was they found a torn abductor muscle that required a big repair. It was torn off the bone and the only time that must have happened was when I first popped out the hip during the 2nd transplant in April 2006. That hurt so bad and the hip never had the same stability afterwards.
I could not have been more please with the superb medical and nursing care I received during the stay. Everyone treated me like gold. The courtesy, respect and professionalism were second to none. Naturally when the nurses learned that MJ and I were NP’s they would often inquire about career options, etc, which is common and something we both enjoy doing so that was fun too. I saw more staff in a half day there than I saw during my entire stay at Presby Dallas for the 1st surgery and never had to wait for any request.
Generally they have you up walking the day of surgery but they left in the epidural overnight for pain control which was great so I was up and about the next day. I am not permitted to bear weight on the right leg till the end of January (8 weeks post op) so the muscle can heal properly otherwise I could bear full weight on the new hip. I stayed in LR for 3 ½ weeks post op until my follow up visit with ortho then had my routine myeloma testing that same week. We got home on December 20th and it was a welcome site. Since I was and am limited by crutches the family took turns sitting with me during the stay. First MJ then my sister, Pat, for a week then Sarah and Chris for a few days each then MJ came back to take me home. I had physical therapy twice a week in our apartment and will resume at the end of January when I can bear full weight on the repaired muscle to build back up the hip.
Our holidays went well. My sister and her husband came down for the week of Thanksgiving and we have a great visit the Christmas and New Years were nice and peaceful and we got to spend time with the kids.
Mary Jo really enjoys her work at TCOM working palliative care and pain management and puts in long hours. The drive to Ft. Worth is so much shorter from the new house. My PECA bosses have been golden giving me projects to do since my clinical time is somewhat limited. Few people are fortunate enough to work such caring and compassionate friends. They are truly a blessing to me.
We also have some Christmas pictures of the dogs which I will attach to the blog.
bigdlehman.blogspot.com
We hope you holidays were great and that you all have a blessed and happy new year.
Love,
Don & Mary Jo