No Promises

A neighbor keeps the snow in our long driveway at a manageable depth. I try to pay for his plowing services or to at least help with gas. He refuses with a smile, saying, “Don’t worry, I’ll keep it clean.” Obviously, snow angels come in many guises.

At present, we have a narrow lane due to three weeks of unrelenting storms. The diligence of my neighbor makes the daunting winter tolerable. Still, the turnaround by the house needs work as it continues to snow.

The dance floor
The dance floor

Lately, I’m dancing a lot with my shovel: one step forward to load, one step back, turn and toss; repeat ad infinitum.

The effort of moving snow by hand erases some doubts. The work is hard but I am thankful I can do it at all. When I returned home three months ago, climbing a flight of stairs challenged me. I could barely lift a bag of wood pellets. Now I’m walking five miles when the roads are clear. And, shoveling a couple tons of wet snow convincingly proves my strength is returning.

I feel good but know the myeloma lurks in the recesses of my bone marrow. The damage often hides until well advanced. That’s the reasoning behind regular doctor visits and sophisticated blood tests. We must keep an eye on its stealthy movements. I strive to be a good patient, assertive and open-minded. I always arrive with written questions. I take notes to counter the tendency of hearing only what I want to hear. Furthermore, I get copies of the lab reports in order to scrutinize the doctor’s interpretation.

Friday, January 2nd, we met at the local hospital. He comes to our town once each week, as there are no resident oncologists in my small community. He’d ordered a new blood test, one that could perhaps certify my response to the stem cell transplant. Previous tests were all of a kind. We’ve been tracking the presence of abnormal protein since my diagnosis over a year ago. The initial result at 90 days out from the transplant pointed to a remission, confirming an interim exam.

Yet the doctor wanted something to reinforce the positive numbers. So did I. The new analysis, a Serum Free Light Chain Assay, takes a look at the ratio between two molecules in the blood of patients with multiple myeloma. I won’t go any farther into the technical details other than to say, the assay is extremely sensitive. It reliably predicts progression of myeloma prior to the appearance of symptoms. In effect, the test shines a light on the myeloma’s activities. We now have a baseline to determine when and if treatment is necessary.


Sunrise after a blizzard
Sunrise after a blizzard

Again, my numbers are excellent. The doctor stated that they indicate I’m in complete remission…almost. I don’t quite meet the guidelines of a stringent complete response. The ratio is not perfect; it resides just above the normal reference range. Nonetheless, this prompted him to toss me a couple of bones. He said, “I expect your myeloma to be stable, unlikely to need treatment for the next year. I don’t need to see you again until the end of February.” Beyond that, no promises… I won’t get ahead of myself. I’ll take my remission two months at a time, doctor visit to doctor visit.

He warned that my immune system remains compromised. The cancer and my immunity are separate problems. He wants me to rest and recuperate for another three months. I can dance with my snow shovel as long as I avoid crowds. Barring a relapse, the doctor said I could return to work in April. That’s great news. I don’t miss the routine chores of being a postmaster but I do miss the people.

Thus ends the first year of this saga. Thanks for visiting. 2009 looks to be interesting.


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