Last week, the first snow of winter arrived. All day, fine grains of powder squeezed through a sieve of cloud and fell like glitter on top of the fence posts and the shoulders of the shrubbery and filled the crevices between the tiles on the garden path. Above me, geese gabbled among themselves, heading south, blind and invisible in the overcast.
The clouds lifted after the snowfall. Streets glistened under sapphire skies. Temperatures plummeted. One day it was five degrees, then one degree, and now, today, a balmy seven degrees at dawn. The frigid weather lends itself to hibernating routines: I take short walks; I write; I tend to the woodstove; I read.
Lately, I’ve been studying immunoglobulins and enzyme blockers as they relate to my blood cancer, multiple myeloma. I’ve learned my immune system operates at less than 50% of the normal base range. It’s not something you can see by looking at me, but a simple lab test reveals the deficiency. Basically, malignant blood cells grow unchecked. They hog space normally reserved for healthy cells that protect a person from germs.
Having cancer is a bit like returning to school. I enjoy studying disease biology and I’m learning the intricacies of blood chemistry. The knowledge helps with managing both the cancer and side effects of treatment.
This month marks six years since diagnosis. My experience is typical of many others living with the disease. We share a variation of myeloma that develops slowly, but with predictable resilience. I’m fortunate we discovered the cancer before complications of bone or kidney involvement occurred. This allowed my doctors and I to proceed with the treatment philosophy of “less is more.”
Ironically, myeloma also goes to school once it inhabits a patient’s bone marrow. Drugs suppress the runaway growth but the cancer inevitably creates new mutations. MM learns to evolve in the crucible of chemotherapy.
Soon, I’ll begin a new drug treatment. The current maintenance program, which I’ve been on for three years, continues to wobble. The MM struggles to gain purchase in my marrow but there’s evidence of serological slipping. In other words, we can see my blood misbehaving even if I remain asymptomatic.
The new treatment, though generally well tolerated, comes with a unique risk and side effect profile. With myeloma the strategy can be likened to a chess match. I have the black pieces. I’m playing defense. It’s my move. I must slow the advance of the latest mutations, while buying precious time as lines of counter attack develop.
Cancer patients don’t like change, especially when they feel well. But the blood labs act like those “pop quizzes” college students hate. Dr. L, my oncologist, doesn’t like the answers she’s been getting. That’s why I’ve cracked the books on the cellular biology of blood. I want to be ready for the next test. And, I want to see those geese return in the spring.
Good Blood, Bad Blood 
Beautiful words. Beautiful pictures. Here’s to watching the geese return next spring.
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I tear up even before I get to the cancer part. All the images are so evocative. I am glad you are in school. I don’t know that I could be so interested in my sparring partner, though clearly that interest is serving you well. And surely, certainly, you will be seeing those geese return for more than just this coming spring. Much love, Janet
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Wonderfully written post. Here’s to next Spring.
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I’ve often though to myself that if you can get past the horror of diagnosis and treatment, cancer can be a fascinating disease. I’ve been in school myself the past six years – always learning either from books or my fellow veterans. So much to learn both technically and emotionally. It’s a confounding disease and takes a tremendous amount of dedication to overcome. Yet, the more I feel I can see inside the disease, the greater chance I have to control it. Knowledge is power as has been said – I try to gain as much of both as I can…. 🙂
Love the photos – that’s where the true moments are…
– J.
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