Search: “shingles”

Velcade & Doxil Update

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I’ve been on Velcade & Doxil since January now, so it’s time for another update. There have been a few cycles during which I missed a dose because of a rash, shingles and a trip to Mayo.

I’ve tolerated Velcade & Doxil quite well, with the exception of the skin problems. I also have a problem with the skin on my hands, which we think comes from the Doxil (HFS). Last Friday when I had treatment, I tried a suggestion from on of my doctors. During the infusion, I held an ice pack in each hand. They call this regional cooling, and more information can be found here:

http://doxil.com/optimize_treatment/managing_side_effect.jsp

What happens to me is that the skin on my hands splits open and the result is soreness and ever-present bandaids.

During my treatment, I receive some IV dex and benadryl to help lessen the hives (rash) that appeared after my second cycle. Since I started having the premeds, the hives have been practically non-existent.

I also have Anzemet, an anti-nausea drug. I’m not really sure that I need it, but I don’t want to find out. I think the Anzemet may be responsible for a headache I get the night of treatment. When there are so many things being pumped into your vein, there’s no way to be sure.

So far, the drug combo has worked for me. My IgA and m-spikes are still not in the normal range, but my bone marrow biopsy indicates that the % of plasma cells is down to 6.2%, and it was 30% last fall after Rev/dex (20% BEFORE Rev/dex).

I plan on staying with this regimen while I think about SCT and other things, and hope that it continues to work (even slowly) while I ponder.

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IgA Turns Around

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I had blood drawn on April 26th and saw th report today. The last one was discouraging, but I was reminded not to panic until we saw a trend. This time, it’s down. The m-spike(s) are a tiny bit lower, too.
IgG: 350 mg/dL (range: 694-1618) Low — 375 on April 8
IgA: 876 mg/dL (range: 68-378) High — 1080 on April 8
IgM: 35 mg/dL (range: 60-263) Low — 23 on April 8
M-spikes: 0.35 g/dL and 0.10 g/dL (no m-spike is normal) — 0.44 and 0.13 last time

I wonder if there’s any way the April 8th test was elevated because of the virus that caused my shingles?

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Skipping dex again

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I’m skipping my dex dose again this week. The doc suggested that I not take steroids while I have shingles. It’s pretty much cleared up now. It’s nice not to have to take the dex, but I think my labs will show that my IgA has gone up. My total proteins are up, and I’ll know what my IgA is later today. I wish I could take a couple of months off.

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Change in treatment

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I’ll be having a change in treatment soon, after having received advice from Dr. Durie. As soon as I can, I’ll start back on thalidomide — just 50 mg, twice a week. I’ll cut back on my dex dose, which is currently at 60 mg a week. I’m hoping to be able to go to 20 mg a week. I need to hold off on this for a short while though. I have a case of shingles that needs to clear up before I can take any more steroids.

I’m taking Famvir 3 times a day for the shingles. You can read more about it here.

I’m really hoping the thalidomide doesn’t cause any further progression of my neuropathy. Dr. D. believes the small dose will be safe. I know enough to stop if I feel anything getting worse at all!

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Velcade notes

Since there are several hundred readers of this blog every month and it’s well indexed in the search engines, I wanted to include this from a member of the ACOR MM mailing list. Please discuss anything that has to do with your care with your doctor. This is just information from another patient and must not be taken as medical advice. The same goes for anything else on this site.

After six cycles of Velcade my IgA is 25, from a
starting level of over 3000 in early March. I feel
great. For this entire cycle I have received a whole
liter of saline hydration with each Velcade
injection. I have had no side effects whatsoever,
other than the temporary worsening of Thal-induced pn
and shingles phn. This resolves in about 48 hours.
When I received a smaller amount of hydration during
the first several cycles, I often had mild to
moderate flu-like side effects of low fever, body
aches, fatigue, and malaise. I strongly urge anyone
who is beginning Velcade to ask your doctor to order
a liter of saline each time, set up as a pump
infusion over about one hour.

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