D day: tentative diagnosis, treatment plan, our decision

D day: tentative diagnosis, treatment plan, our decision, determination

Add dread to the possibilities of testing all week, getting totally exhausted, and finally getting face to face with the doctor, who armed with a 2 inch thick file begins to describe your future quality of life..if any.

That's what we did about noon today!

Dr Bijay Nair, MD, MPH, is Deb's doctor. He reports to the world's number one expert in Multiple Myeloma research and treatment- Dr Bart Barlogie, MD, PhD, who came up from MD Anderson in 1989 to establish this center.

Dr Nair is from India and Amanda immediately hit it off with him when she found out he was from the very town she and Jon had been to when they spent time there helping the people hurt in the tsunami a few years back. Dr Nair had a tear in the corner of his eye while thanking Amanda going there.

Back to the report folder: Dr Nair gave an overview of what we were going to do and proceeded to explain all the reports from each test and what that means to Deb. There are several reports that will not be back until next week including the all-important and exclusive to this center Gene report which will determine the aggressiveness of Deb's case.

Dr Nair confirmed that Deb does indeed have multiple myeloma including seven spine fractures, some damage to her skull, her sternum, and hip bone,plus other spots. He spent 2.5 hours with us in a small room and answered a million or so questions, and finally outlined our potential treatment plan. He gave us much hope for the future and pointed out that many information sources paint a much bleaker outlook for myeloma than are being seen at this center. If our complete diagnosis when complete is as he expects, we would attack this disease here for the next six months, then enter a carefully monitored remission.

There are various treatment philosophies in the medical community he explained. The two main ones are to treat some and watch a while to see what a particular drug does, then try something else and see what it does. The other one which is practiced here is to very aggressively use a combination of drugs which individually are only somewhat effective, but when combined, have a synergistic impact on the disease. Then, dual bone marrow transplants are made to re-establish healthy bone marrow. Then, a rest-of- life monitoring occurs at 3 to 6 month intervals.

The bone marrow transplant is not the old look-for-matching-donors around the planet. Instead, the patient is the donor. How's that??? Take marrow from a sick person, heal the disease with chemo cocktails, then inject the 'sick' marrow back into them? Yep! That's how they do it.

Here are some details we laymen do not know: It is the stem cells which do the work. They are immature basic cells that can become anything the body needs them to become.So, by capturing at least 20 million of these cells and freezing them for future use (about 5 million needed per transplant), there are multiple opportunities to rebuild the marrow with cells that are not subject to the rejection problems that using someone else's might pose. Pretty cool, huh?

So, today any doubts about where we want to be treated vanished. This center is a total solution with total support in our life-and-death battle against this terrible disease. The staff,facility, community, technology, reputation, and our confidence gained in a week spent deep in the bowels of this center give us hope for a future together. Oh,it will certainly be different than we had planned, but it will be good and Deb and I will cherish each moment. We have hope for long term remission, and thank the Lord for leading us here and for his provision for this adventure in faith. Join us in worshiping the true healer into whose hands we are committed.

Regarding determination: Deb has amazed me with her strength in the midst of total physical weakness. She has a poster a friend gave her which shows a determined small tree hanging on and growing in a harsh desolate rocky crag. That is how she is handling this. She is an amazing woman!

My understanding of all this is very elementary and I invite Deb and Amanda to correct or amplify my writing. I really did want to get some news out today for all those supporting us.
Vern