1939 / Class of '03 / Bone involvement, kidney failure / Chemo / Died: 10-27-03
My father grew up on a farm and has been a truck driver for most of his adult life. While working on the farm he was exposed to pesticides used to treat cotton fields. While working as a truck driver he was exposed to petroleum products while fueling the truck only. I do not know of any source of radiation exposure.
My father has not had any significant health problems in his past. He had his gallbladder removed approx. 10 years ago. He was a smoker, but quit in 1988. He does have emphysema. His doctor told him his heart rate was irregular about four years ago and for that he quit drinking soft drinks and eliminated caffeine from his diet. No problems with the irregular heart rate since then. Most recently he had a lesion on his ear that was removed (skin cancer)
My father, Jack, was recently diagnosed with Multiple Myeloma on August 14, 2003. His symptoms started on June 16, 2003 when he hurt his back at work. My father had partially retired from full-time work and was making one to two trips a week, working part-time. Dad turned the incident in on workman's comp and was treated for low back pain with muscle relaxants. The back pain became increasingly worse and he was referred to a chiropractor by one of his friends. This didn't help either. The back pain continued and he ended up going to the ER one Saturday in July. The ER physician ordered an MRI of his back. Dad received a call from the ER doctor who told him he had two compressed discs. The ER doctor also told my father that he had blood in his urine.
After weeks of not being able to figure out why his pain was getting worse and worse, my father finally turned to his family doctor. Dad explained the events leading up to that day to his family doctor who ordered a 24-hour urine and a skeletal survey. The 24-hour urine showed Bence-Jones proteins and the skeletal survey showed four compression fractures in his vertebrae. The same week Dad returned to his office and was told that the protein in his urine was indicative of bone cancer. Monday August 11, 2003, I accompanied my Dad to the oncologist who performed a bone marrow aspiration in his office. We were to return to the oncologist on Thursday of that week. On Wednesday, a day early, we received a call from the oncology office requesting that Dad return immediately to their office. When I met Dad at the office, they already had him in the treatment room. I explained to the nurse that Dad didn't even have the results from his bone marrow biopsy. The doctors' PA came out to explain that Dad's calcium level was 12.5 and they were going to treat him with a bisphosphonate. The next day we returned to the oncology office and his physician confirmed that the bone marrow biopsy was positive for an elevated number of plasma cells and that Dad's Multiple Myeloma was a Stage III.
Due to the pain, the doctor admitted my father that day to the hospital to treat his back with radiation. While Dad was in the hospital, they treated his back with 10 rounds of radiation. He received chemotherapy (Vincristine & one that started w/ an A) in a CAD pump over a four day period. He also fractured a rib while in the hospital, so they treated that with five rounds of radiation too. While Dad was in the hospital he was seen by a urologist, a Foley catheter was inserted because he was having difficulty urinating. The bladder scan in the hospital showed retention of > 800 cc's of urine.
Dad went home from the hospital on Aug. 29 and has been at home since that time. He uses a walker to assist him from the bedroom to the bathroom. His back pain is much more tolerable since the radiation. Dad returned to the oncologist on Sept. 4th and his white count was very low. He was sent home with neupogen injections and received one a day for three days. We buzzed his hair this week since it's already started coming out on it's own. He looks cute with the buzz cut.
Dad continues to struggle with nausea, decreased appetite, and he still has blood in his urine. Dad has lost 50 pounds since April 2003. Last week, my Dad was given a sample of anzamet (for nausea) and this seems to be the best med we have tried so far for nausea. Dad went to the urologist last week and they removed the Foley catheter, but this week his urine has became very dark and red. He is going back to the urologist this week, possibly for a cystoscopy.
We are very hopeful that the chemo and radiation have a positive impact on Dad's disease, and we are thankful for the radiation that eased his bone pain. I will update my Dad as a survivor of Multiple Myeloma as many times as possible.
September 15, 2003: On Friday, Sep. 12th Dad was given Zometa (Bisphosphonate) again for bone strengthening, in the doctor's office.
Sunday, Sep. 14th, Dad was admitted to the oncology unit for severe dehydration. His creatinine level is up, he continues to have blood in his urine (maybe the urologist can perform a cystoscopy this week while he is in the hospital), and he became mildly confused over the weekend prior to his admission. He's lost 60 lbs now and is averaging losing about 10 lbs per week. He can't keep anything down, not even liquids. Dad has told us that he does not want a feeding tube.
We have an appointment to take Dad to the Multiple Myeloma Institute for Research and Therapy in Arkansas on Sept. 27th. The institute completes a four day evaluation of Multiple Myeloma patients who can then return to their primary local oncologist with a treatment plan. The institute is performing genetic testing on MM patients which helps predict which chemo the patient will most likely respond to. However, now that Dad is back in the hospital, his physician isn't sure if he will be up to travel by then or not.
Our family and friends have been overwhelmingly supportive! We are truly blessed! If they are reading this story, we THANK YOU. We are planning a golf tournament for Dad, he loves Golf, and we loved playing golf with Dad.
September 23, 2003: Dad has been in the hospital since September 14th. He was admitted because he could not keep anything down, not even his medications. The doctors told us on Monday Sept. 15th that Dad was in renal failure. They were hopeful at that time that it was acute (related to his dehydration and urinary tract infection) and not chronic (irreversible and related to his cancer) Creatinine at the time of renal failure diagnosis was 10.5 Dad has received several days of dialysis since that time. The most he goes without a trip to the dialysis unit is one day. The lowest his creatinine has been is 4.7 (Normal is 0.7-1.5) Dad is on a morphine pump for pain, he has TPN / I.V. nutrition, an N/G tube, a Foley, and he's on 2-3 liters of oxygen. On Sunday, Sept. 21st, Dad quit responding to our conversations with him. He simply sleeps. On Monday morning, the urologist scoped Dad's bladder at the bedside. Results: inflammatory changes, no stones, no obstruction. On Monday night his oncologist came in to talk to our family. The doctor said he didn't really understand why Dad was so lethargic and that he was concerned. He ordered an MRI of Dad's head. This morning (Tues.) Dad is responding and talking again.
October 10, 2003: Dad is still in the hospital at FRMC in Hickory. His MRI was normal. He continues to take dialysis 3-4 times a week. He has I.V. nutrition (TPN) He is on 3-3.5 L of oxygen and still has a Foley catheter. He's not eating much at all, he eats very small portions at each meal. We asked his doctor to contact UNC Chapel Hill to see if Dad is a candidate for a bone marrow transplant. The doctor came back a few days later and told us 'NO' They told us when he was admitted to Frye this time that we probably wouldn't be able to get him to the Arkansas Multiple Myeloma Institute either. Dad had his second round of chemo last week and has been sleeping a lot since then, he has also had another unit of blood. They x-rayed Dad's shoulder this week because he has been complaining of shoulder pain. It's not broken, but definitely has signs of MM tumors / punch out holes present. Dad may be going home from the hospital next Monday. We are getting him set up with a hospital bed, bedside commode, and a recliner. He will take his IV and pump home with him. Wish us luck. Transporting him back and forth to the hospital for dialysis will not be easy.
October 14, 2003: We took Dad home from the hospital. He spent one night at home and I must say, he slept more peacefully there than he had in a long time. The next day my mother took him to dialysis and when my brother and I went to pick him up, Dad was completing his dialysis treatment. He was able to stand and move over to the wheel chair, but once in that chair he passed out and had seizure activity. We took Dad back to Frye where he was readmitted to the oncology unit. The nurses welcomed us back with open arms. The next morning they placed a feeding tube in Dad, in hopes of getting him strong enough to go home. The feeding tube didn't work either, Dad continued to get very sick and was not able to keep the feedings down.
October 21, 2003: Dad's oncologist met with me and Mom and we discussed quality of life, which for my Dad by this point was not good at all. The doctor told us that that the second round of chemo didn't do any good and that prolonging aggressive treatment was not his recommendation. We struggled so hard with the decision and finally and unselfishly decided it would be best not to prolong the suffering. Dialysis was discontinued.
October 27th, 2003: Dad went home to be with the Lord and all of our loved ones that have gone on before us. We know that he is in heaven watching over us.
I miss my Dad and life without him will never be the same.
Anita Roper, firstname.lastname@example.org
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