One Hundred Days

July 31, 2013

Mary and I met with my Winship Clinic Oncologist yesterday at Emory University. This appointment was a very important one in my treatment because it provided the opportunity for us to do some thinking and decision-making based on his evaluation of the data from my recent bone marrow biopsy and monthly blood analyses in the one hundred days since my stem cell transplant.

Major points discussed were: kidney and liver function in normal range, protein level in the blood (M spike) is now 1.19 which is down from 6 in January – this is a seventy-eight percent reduction in protein. Protein in the blood is a key tag in assessing cancer in the system. My doctor was looking for a ninety percent reduction from the transplant. The bone marrow data revealed that there was five percent myeloma in the sample as opposed to thirty percent myeloma in February 2013. Overall, my body’s response to the bone marrow transplant was good, but there is still some residual disease. This is common in successful transplants. Further action is often needed to achieve the goal of 100 percent remission.

Three options were presented for further treatment:
1. Initiate a maintenance regimen of Revlimid
2. Begin melphalan chemotherapy and undergo a tandem or second transplant – The data supports a second transplant – there are plenty of my harvested stem cells available in storage at Emory University Hospital. Tandem stem cell transplants are almost always done at the University of Arkansas Myeloma Institute and sometimes at the Winship Cancer Institute at Emory.
3. Initiate a maintenance regimen of Pomalidomide, newer version of Revlimid, which is used for resistant cases of multiple myeloma.

We made the decision to start Pomalidomide therapy as soon as possible. My Winship Clinic oncologist will monitor my regular lab results closely. If he does not get the desired response within a month or two, he will proceed to perform a second stem cell transplant. I am guessing that this would be conducted in October. My doctor says that he will keep me on “a tight leash with this option.” The goal is CR – complete remission.

As is my habit, I offer a final word or two. First, I am indeed blessed that the results of the stem cell transplant conducted in April 2013 were successful and good. Second, I am glad that I have two excellent oncologists working together on the treatment of my multiple myeloma. One is my “home” oncologist in Alpharetta and the other is my Winship Clinic oncologist at Emory University Hospital. Interestingly, both are friends from their training days at Emory. They are gifted in their field and are keen on data. My Winship Clinic oncologist settles for nothing less than success and is driven by it as he maintains his reputation in the field on a national level. When he says CR, he means to have it, if he has the likelihood of achieving it. That appeals to me; that is the way that I measure my own success!

So, maintenance with “Pom” begins soon and close monitoring follows. If the data shows CR, then excellent and “Shout hallelujah! Praise God!” If not, then a stem cell transplant will be scheduled. As the data shows excellent results from a tandem transplant, then so be it. I know that a stem cell transplant is no “walk in the park,” but I can do it. I am thankful.

July 31 is the two year anniversary of my diagnosis of multiple myeloma.

Mike Green
July 31, 2013

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June Ramblings

June 3, 2013

School’s out for summer! Having had a career in education for thirty-two years, I can identify with the excitement on the part of teachers, students and parents. Although the summers are not as long as they used to be for those who work in education, it is still a time to recharge the batteries.

Families are already standing in lines at Disney resorts, staking claim to their slices of beach, or packing kids off to summer camps. My father is readying his travel camper for some short trips. Folks are pursuing hobbies and enjoying leisure pastimes.

In years past, I would often teach a few weeks of summer school for “project money.” Mary would teach summer school for the same reason. After we became school administrators, we really could not devote the fewer free weeks to teaching summer sessions. Summer was always a big time for my garden projects. These varied from maintenance jobs in the yard to extension projects: a new garden room or upgrading turf to sodded hybrid Bermuda.

In July 2011, I completed my last garden, The Serenity Garden. It is almost a secret garden (some of the plantings are close to enclosing the space). This year it looks to be maturing nicely. Now, the heavy-duty jobs have to be contracted out to landscape workers. We all have some jobs that we can handle. I am able to use a hand-held gas blower in my small jobs. In years past, I used a backpack blower. I tend to point more, instead of bending over to do a job. I tend to give directions or reminders of landscape jobs that a paid worker can do. Finally, Mary weeds and prunes more than she has done in earlier years. Thanks, Mary!

My restraint in doing gardening chores has increased for my own self-preservation. This new normal has not been especially easy for me, but I am proud that our standard for gardening has suffered little. Thank you, Mary, for being such a great gardener. Will and Evan help whenever a job needs doing, as well.

Blooming now: lace-cap hydrangeas (blue and pink)oleanders, ligustrum, roses, eight-o-clocks, Stella d’oro daylillies, ice-plant, oak-leaf hydrangeas, magnolias and very soon, Yuccas. The yuccas bloom every two years, so their blooms will be an event this year.

Gardening has always been a passion of mine. It remains so still.

Mike Green

The yuccas are pictured in bud. Flowering pics will come soon.
The Liddell heirloom rose was just prolific with beautiful shell-pink blooms.

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Looking at the Last Two Days

May 1, 2013

It was Monday, April 29, 2013, that I began to believe that I might actually start to feel differently: better.

The engraftment period of the Bone Marrow Transplant started working right after the transplant period, but I did not “feel good.” In fact, it felt like there were only going to be weeks of diarrhea, no appetite, nausea , negative thinking and weight loss. The inevitable question for the patient undergoing such treatment is: is the treatment really worth all of the almost intolerable side-effects? The debilitation starts to get the most positive thinking low, down, and dirty. When that happens, rather than see people, talk to them, communicate through social media, or simply read, I isolated and hoped that I could get through the days without alienating family or friends. Prayer and positive energy from others helps counteract the excess of all the negatives. You play a waiting game of “when?”

Reassurances from professionals help somewhat, but the dark days don’t just stop.

Or, do they? I told Mary that I had a better BM Monday. Too much information? Sorry, but it is huge to people in my situation who live on Boost for many weeks. One becomes adept at describing bowel activity. Ever had a nice iced chocolate Boost for three meals a day? Or smelled horrid phantom, hospital turnip greens when you were miles away from the offending greens? I am sure that most cannot grasp the disgust that enters the heart of a BMT Patient who smells from afar the awful, prohibited reek of popped and burnt microwave popcorn. Many of you will have no trouble picturing this BMT patient personally tracking down a “civilian” offender near his hospital room? I restrained myself and directed the problem to a nurse, though. That was all for the best, I know. But, I was more than ready to offer up some “commentary” to the individual. Though signs are posted, some cannot or will not read warnings about how food smells affect the patients. My appetite began to pick up, due to great degree by Mary’s monitoring of my GI functioning. My appointment Tuesday at Winship Clinic and Emory Hospital made for a great and eventful day because I had the tri-fusion line that had allowed infusions and transfusions directly into my heart removed. Mary would have no more dealing with three large lines hanging out of my right pectoral muscle. She became proficient in several at-home nursing procedures. Health care pros have heaped much praise on Mary’s abilities. I stand in awe of my Mary! Possessing tremendous patience and excellent nursing skills that helped me survive are two qualities that Mary demonstrated often. My physical strength has been letting me know that I can improve. Motivation to read, the action of deadheading a rose, and the growing desire to do an occasional job in or around the house are cues to me that I am improving. The actions and functions that come back are blessings that appear as a warm, clearing sky that inspires me after weeks of misty, cold weather that cast an impenetrable gloom during the early days of my recovery.

The dark days of recovery are passing more quickly. God gives us the ability to recognize even the smallest signs of hope and recovery if we work at doing so, even if we are very down. There were many days when my mouth and throat were in a battle with sores and swallowing was a chore. Those days are reduced to brief memories today.

God has put people in my orbit who have touched my life and recovery throughout my health crisis. He has continued to do so this week. The staff at Winship says numbers are looking normal for my blood chemistry. Individuals have blessed me with comments to one of my feeling bad blogs. Thank you, friends and family, healthcare professionals, and my fellow patients when we speak or simply smile at one another. When the BMT patient fell in the Winship Clinic waiting area yesterday, that could just as well have been me. I pray that he bounces back and fights his disease in his own way. We have to learn to make our way for ourselves, or we are defeated, indeed.

Thank you for your interest, prayers, and words of comfort.

Mike Green
May 1, 2013

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Post-Transplant Update

April 27, 2013

My hospital stay is over and my transplant is doing well. The numbers are where the doctors want them to be for now. I am pleased and thankful that the news is positive.

I just have to endure the resultant bad feeling that is my current state. Lethargy, nausea, feeling down, and no interest in reading or projects has made me feel that I am not improving. The numbers give a different story and I am told that the ill feelings will pass in a few weeks. I am looking forward to that!

Thanks to all the medical professionals, my friends, and families for your care, concerns, and prayers. I hope to get through this downside soon! Love to all!

Mike

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Challenge Week

March 22, 2013

This week has been interesting in that it was a “testing” week for me. The old expression comes into play, “that which does not kill us makes us stronger.” Nietzsche may have had that right. I will say that I am getting stronger after the events of this week.

The first round of testing came on Sunday with lethargy, low blood pressure, and nausea. This was enough to send me to the Winship Infusion lab for a blood chemistry check. The results showed no glaring issues. I was almost sure that Hematocrit was low enough for a transfusion of blood. Low BP and heart rate in the hospital the last week in February were making me think that this was happening again.

Turns out a bag of saline and a reduction in blood pressure medication, helped dispel the lethargy. The saline was needed for dehydration due to my rampant diarrhea. While in the hospital, I picked up a nasty c.diff infection in my gut. The doctors agreed that a reduction in the BP medication would be appropriate. The spasms in my leg presented another challenge Monday evening.

I fell in our dressing room. All the way to the floor, I fell. Hitting my head in the process, my life and plans started flashing in my mind at that midnight hour. No matter how careful one tries to be and no matter that Mary was with me, I still fell. I managed to lie in the bed, my mind whirling. I did manage some sleep, but I knew that I needed to have x-rays or scans. I called in the troops, and Evan, Will, and Mary managed to get me to Emory ER, Tuesday mid-morning. I needed a wheelchair which was not to my liking, but it helped. I am relieved that I had one. My doctors alerted, said to come straight to Emory ER.

If you have seen the movie, Beetlejuice, you can identify with the wait in ER. Late afternoon, I rode to imaging. Long story short, there were no breaks or displaced screws or rods in my body. Thanks be to God! I returned home with a sore and defeated body, Tuesday evening.

Since then, I have begun to feel better. I can eat meals, and my BP is normal. I am still sore, but that is improving. I am back to my cane in the house and a walker for outside. The medication for the diarrhea and the c-diff have almost been completed! Hooray!

You may say, that I dodged the bullet on that score and am still on track for my transplant in twelve days. I know God’s will is being done, and for that I am thankful. I thank my family and Mary for helping me in so many ways.

It has been a challenging week, but one in which new perspectives have been noted. I am happy and I am blessed.

Mike Green

Day Four at Emory (re-posted)

February 28, 2013

Blogging about the minute details of my health challenge is not on the top of my urgent “to do list” for two reasons:

I get distracted (adult on-set ADD, perhaps?).
People need to read to escape the trials of everyday life as much as possible.

When I don’t blog, I have a watchdog ( and he knows who he is) who jacks me up! So, I will save him the effort, this time! I am planning on returning home Friday evening and feel compelled to get this entry done, anyway.

The super chemo treatment in the Bone Marrow Transplant Unit at Emory University Hospital has been preparing me for the transplant process that begins on March 11th. I am planning on returning home tomorrow evening and I am happy about that, even though I have fallen in love with the doctors, nurses and staff here at Emory. After that week of outpatient collection (harvesting!) of my stem cells, the cells are frozen and stored for my return in April for the two week transplant and recovery. This is the time when the old immune system takes a high dive. After that…monitoring and maintenance takes over. There will be a quiz tomorrow on this process for my readers. The old teacher in me does surface.

I’ll keep this blog entry short (I have to call in my dinner order). I must thank some folks.

The posting of messages on Facebook by friends and family have been inspiring and heartwarming. Saying a simple thank-you seems trite, but is often the most effective way to say what one feels deeply. Thank you, friends and family, for your prayers and messages. They sustain me. Thank you, Mary, for the wonderful love and care you give me. Finally, I have enjoyed the cracked humor that so many of you have demonstrated, as well!

Oh, a last note for this entry… I have been making a movie on my iPad for the last three weeks. I have been ecstatic and, at times, frustrated by the process. The iMovie is the culmination of a project that has entertained me for years since I was a young kiddo. It is about my family history with some connections to the early history of Atlanta and Gwinnett County. It’s for my boys. Also, the old teacher in me also has to tie up his genealogical research with a project to show. I plan to post some excerpts on Facebook and YouTube. Just no grading permitted, folks!

Thanks for reading!

Mike Green
February 28, 2013

(1st photo: Liddell Homestead, Gwinnett County, c. 1900; 2nd photo: “The Battle of Atlanta” in the Cyclorama; 3rd photo: Grandmother Nellie Mae Mills Liddell and Mike, early 1980s, Gwinnett Daily News)

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Sunday Enjoyment

February 17, 2013

Mary and I picked up PawPaw and headed to Peachtree Road United Methodist Church to meet Evan and Sarah for the Communion Service that featured Will in a lovely solo, “The Seven Last Words of Christ.” This is a piece that we have enjoyed since we were members of Lawrenceville First United Methodist Church in the 1980s. It is one of Mary’s particular favorites. When we heard that Will had been asked to sing it, we were very pleased.

His singing was lovely and inspirational with many accolades from church members. After the service we went to Front Page News and celebrated Evan’s Valentine’s Day birthday. We had an excellent meal and visited with Evan and Sarah at their house for a good long time before heading back to Duluth to drop Pawpaw off at his house. By the time we got back home we had made a full day of it.

It was a day to remember!

Mike Green
February 18, 2013

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