MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'dexamethasone'. Sat, 03 Sep 2011 02:31:15 +0100 http://www.medworm.com/index.php?rid=4411525&cid=t_146640_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdrug-safety-in-preventing-acute-mountain-sickness%2F2011.01.28 This is a guest post by Dr. Jeremy Windsor. ********** Steroids and Acute Mountain Sickness In recent years, many attempts have been made to identify safe and effective medications to prevent acute mountain sickness (AMS). Acetazolamide (Diamox), currently the “drug of choice” for this purpose, is not perfect and occasionally causes objectionable side effects. Dexamethasone (Decadron), a powerful steroid medication, has become increasingly popular for prevention and treatment in certain circles. While there is ample evidence to suggest that dexamethasone is effective, a recent case report highlights that this drug is not without risk. In the latest issue of the journal Wilderness & Environmental Medicine [WEM 21(4):345-348, 2010] in an article entitled ”Complicat... Better Health blogs http://www.medworm.com/rss/comments.php?id=4411525 Fri, 28 Jan 2011 22:00:00 +0100 4411525 http://www.medworm.com/index.php?rid=3633585&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2010%2F06%2Finnovative-treatment-for-relapsed-and.html Friday night I attended a satellite session hosted by Celgene, the makers of Revlimid and other drugs. Dr David H Vesole, of Hackensack University Medical Center, focused on the newest treatments for myeloma. He said that the two most important tools are Revlimid and Velcade (and he might as well have included dexamethasone (DEX) because it is almost always combined with Revlimid and Velcade). The new kid on the block is all three, termed VRD. In one study it produced a response in 100% of patients, and a very good partial response (VGPR) or better in 75%. That's pretty amazing. Unfortunately, though, 15% of patients experienced severe neuropathy. Other studies suggest that low-dose DEX may work as well, and with once-weekly Velcade instead of twice-weekly, neuropathy may be reduced to a ... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=3633585 Sat, 05 Jun 2010 19:41:00 +0100 3633585 http://www.medworm.com/index.php?rid=3436372&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2010%2F04%2Fapril-fools-test-results.html Discussion with Dr KDS: Bone Density: Dr KDS had looked at last month's DEXA scan and told Dr D, a Mayo bone-health specialist, that my myeloma is under control but that I am a runner and a fracture would be devastating (like it wouldn't be for anyone!). My densities are: Femur necks: T-score is -1.1, indicating mild osteopenia. Density for each is about 0.93 g/cm(sq). This is down about 3% from 2003, though Dr D didn't know about previous scans. Lumbar spine: T-score is -1.2, indicating mild osteopenia. Density average for L1-L4 is 1.08 g/cm(sq). This is down about 4% since 2003, also unknown to Dr D. Dr D suggested Fosamax (alendronate) 70 mg per week, for not more than five years. I have a lot of faith in my PCP Dr L, and told Dr KDS that I would discuss this with him and get the pre... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=3436372 Sat, 03 Apr 2010 19:06:00 +0100 3436372 http://www.medworm.com/index.php?rid=3339771&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2010%2F03%2Fmarch-4-2010-end-of-cycle-26.html Discussions with Dr L: Biaxin (clarithromycin) is known to potentiate the combination of DEX and an IMID drug, such as Revlimid or thalidomide, and probably pomalidomide. Biaxin is no help by itself, and no one knows whether it would work with ONLY the IMID drug, without the DEX. Dr L prescribed a three-day course of Biaxin a month ago, to prevent a minor skin injury from becoming a major infection. Could those three days of Biaxin have helped the pomalidomide work on my tumor burden, even though I'm not taking DEX, and even though only three days? She looked at the skin injury, now just a red spot, and thought it was healing rather slowly. In contrast, I thought it was healing fairly quickly compared with similar, prior experiences on DEX. I asked if neutrophils are important to wardin... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=3339771 Sun, 07 Mar 2010 01:05:00 +0100 3339771 http://www.medworm.com/index.php?rid=3157645&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2010%2F01%2Fwhen-receptionist-knows-your-name.html January 7, 2010, end of Cycle 24: You know you're battling cancer when the receptionist at the Mayo Clinic Hematology desk knows your name as you walk in. Happened Thursday. 24 cycles of the pomalidomide (CC-4047, Actimid) study are complete, and it's been a great ride. Not over yet, but Thursday was a hint that it might be over before long. Or was it a hint? The worst news, really, was that M-spike went from 0.9 to 1.0 g/dL. I stopped dexamethasone (DEX) completely for this cycle, the first cycle without it, and M-spike inched up. Maybe. Although M-spike tracks the tumor burden most closely, it is not especially accurate, and IgG only went up a little, from 1090 to 1100 mg/dL, so maybe it didn't really change. IgG is a measure of ALL immunoglobulins, including the monoclonal ones that m... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=3157645 Sat, 09 Jan 2010 22:54:00 +0100 3157645 http://www.medworm.com/index.php?rid=3083170&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2009%2F12%2Fno-more-dex.html YAY! After 23 cycles of pomalidomide (CC-4047, Actimid) with dexamethasone (DEX), I've taken my last DEX tablet, at least for a while. Recently I've only been taking 4 mg per week anyway, which probably doesn't do a lot of good but certainly seems to induce most of the same side effects as a larger dose. Thursday's results (December 10) again show the myeloma to be stable. M-Spike, IgG, and light chains all about the same as 28 days ago. Stable is good - my myeloma and I are at a standoff. Let's hope that continues without the DEX. More actual test results are listed below and from the righthand panel. Ashwagandha: No noticeable improvement, so clearly the ashwagandha isn't helping much. Of course it's possible that the myeloma has begun to figure out the pomalidomide, so M-spike would ... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=3083170 Sat, 12 Dec 2009 20:39:00 +0100 3083170 http://www.medworm.com/index.php?rid=3030062&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2009%2F11%2Fmayo-clinic-cycle-22-still-stable.html Discussion with Dr. L: She finished a recent marathon in a very nice time, despite having to wear a lot of clothing to keep warm. She thinks that my running inspires hers. As for me, I'm very proud of her. In answer to my question, yes, get a pneumonia shot. If ashwagandha didn't help in the first month, maybe in another month. There is a study of an oral form of Velcade. There is also a study of a drug currently in use for renal cancer. The pomalidomide trial is now open for people who have failed both Revlimid and Velcade. American Society of Hematology (ASH): Apparently it is unusual for a myelomiac to be able to run marathons. Thus far I have been lucky enough to avoid broken bones, and I've done eight marathons this year. The International Myeloma Foundation (I... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=3030062 Wed, 25 Nov 2009 21:39:00 +0100 3030062 http://www.medworm.com/index.php?rid=2923434&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2009%2F10%2Fashwagandha.html Discussion with Dr. KDS: Don: Peripheral neuropathy from the pomalidomide has not changed much in this cycle. Still some numbness in the bottoms of my feet and in my thumbs. There is also a little tingling but no pain. The "tickle" sensation in my feet, sensitivity to light touch, might actually have improved somewhat, but the sensitivity to pressure has definitely not improved. Many myelomiacs get shingles, because of compromised immune systems. I'd rather not, thank you. So I asked Dr. KDS about the shingles vaccine: It is a live-virus vaccine, and not recommended for people who are immunocompromised; but I don't get sick much - no empirical evidence that my immune system actually IS compromised, but She pointed out that IgA, IgG, and IgM are important parts of the immune system, an... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=2923434 Fri, 23 Oct 2009 19:40:00 +0100 2923434 http://www.medworm.com/index.php?rid=2809866&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2009%2F09%2Fmayo-clinic-visit-thursday-september-17.html Discussion with Dr. KDS: Don: Peripheral neuropathy from the pomalidomide might be a little worse. It measures the same, but may have increased in areas that I don't measure, such as the backs of my hands. It does not interfere in my lifestyle in any way. There is no sensation from it unless I'm stepping on my feet. There are no red bruise marks on my arms this time. Did the reduction to 4 mg DEX make my skin less sensitive to bruising? I'm probably not getting slower (running) any more - maybe a little faster, though that may be psychological. KDS: Wants me to stay on the current 4 mg dosage of DEX for at least 2 cycles before discontinuing it. So at least one more. DEX can cause steroid-induced myopathy, but my modest reduction in muscle capacity does not qualify. Muscle wasting is prob... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=2809866 Sat, 19 Sep 2009 11:28:00 +0100 2809866 http://www.medworm.com/index.php?rid=2748125&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2009%2F08%2Fimf-patient-family-seminar.html Friday, August 28, and Saturday, August 29: The International Myeloma Foundation (IMF) Patient & Family Seminar was interesting and information-packed, to say the least. We heard doctors from all around the country discuss topics like Ask the Expert, Managing Side Effects, Frontline Therapy, Role of Transplant, Bone Disease, and Approaches to Relapse. I think that about 100 of us myelomiacs attended, many with their caregivers. I've been dealing with myeloma for six years now, so a lot of the information was not new, but here are a few things that I learned, or perhaps re-learned: Transplants: It appears to make little difference in overall time of survival whether the transplant is done early or late, as long as stem cells are collected early before the bone marrow gets all beat up. A ... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=2748125 Mon, 31 Aug 2009 01:10:00 +0100 2748125 http://www.medworm.com/index.php?rid=2725219&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2009%2F08%2Fmore-great-news.html Discussion with Dr KDS: My neuropathy has not become worse in the last two or three months. It reached a level where the balls and heels of both feet are partially numb, along with one thumb, and then it stopped advancing. It's quite livable, barely noticeable most of the time. I've lost four pounds in the past two months. Maybe. If so, it would be a very good thing. I have the usual litany of dexamethasone (DEX) complaints: Thin, aged-looking skin, easily bruised, Slow healing of wounds, Slow running - muscles wasted, and A new complaint: Sleep is hard to come by the night after "DEX day." I have been taking 8 mg of DEX once per week, and that will be reduced to 4 mg from now forward, by agreement of Dr L, Dr KDS, and myself. The next lower level of DEX on this Phase II Pomalidomide ... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=2725219 Sat, 22 Aug 2009 18:20:00 +0100 2725219 http://www.medworm.com/index.php?rid=2442568&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2009%2F05%2Fneuropathy-is-issue.html Mayo Clinic Visit Thursday, May 28, 2009, end of Cycle 16: Peripheral Neuropathy: I posted about the possible beginnings of peripheral neuropathy (PN) eleven days ago. In those days I have taken most of the supplements listed on my Supplement Regimen page. The symptoms have not disappeared, however, though they have changed a little, and I am still not certain (beyond a reasonable doubt) that the feelings in my thumbs and feet are in fact PN from the CC-4047 medication. There is normal sensation, or I should say no sensation, from the affected areas unless they touch something. One thumb always feels fine now, and the other, which was injured and its nerves cut many years ago, does tingle when touched, though the thumb pad is still sensitive to touch in the normal way as well. The soles... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=2442568 Thu, 28 May 2009 21:47:00 +0100 2442568 http://www.medworm.com/index.php?rid=2382759&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2009%2F05%2Feven-better-news-probably.html Mayo Clinic Visit Wednesday, April 30, 2009, end of Cycle 15: Results: CC-4047 is an analog of thalidomide and Revlimid, presumably an advancement on both. One little-advertised feature of Revlimid is that a patient's M-spike may decline in two phases. The first phase may take the spike down to a plateau, and if there is a second phase it may produce another gradual decline to even lower numbers, possibly much lower. Dr L has a theory that the first phase may be the Revlimid actually killing the naughty plasma cells, as we might expect, and the second may happen because the Revlimid has helped the immune system itself to fight the myeloma. The good news for me, perhaps, is that CC-4047 seems to show the same two-phase response for some patients, maybe including me. The CC-4047 study is ... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=2382759 Sat, 02 May 2009 19:34:00 +0100 2382759 http://www.medworm.com/index.php?rid=2326663&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2009%2F04%2Fgood-news-again.html Mayo Clinic Visit Wednesday, April 2, 2009, end of Cycle 14: Results: M-Spike is the same at 0.9 g/dL, IgG is up slightly from 923 to 1060 mg/dL, and Lambda light chains are also up a little from 2.64 to 3.04 mg/dL. I'm not concerned about IgG & light chains, because those numbers do seem to fluctuate a bit from one cycle to the next, as does the M-Spike for that matter. Taking the long view, these major markers have been level or down since June, 2008, and the trend is pretty much level. This is great, and Hooray for modern science! CC-4047 is an experimental drug, an analog of Thalidomide and Revlimid but apparently more potent and with fewer side effects. In early March, a year ago, I started on the Mayo trial of CC-4047 with dexamethasone (DEX). By June, M-Spike dropped dramatically... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=2326663 Fri, 10 Apr 2009 14:08:00 +0100 2326663 http://www.medworm.com/index.php?rid=2241633&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2009%2F03%2Fbetter-than-plateau.html Mayo Clinic Visit Wednesday, March 4, 2009, end of Cycle 13: Great News! A month ago, at the end of Cycle 12, M-Spike went down from 1.1 g/dL to 1.0 This month it went down again, to 0.9 g/dL, for a total drop over two cycles of 18%. Further, in that two-month period, IgG dropped from 1350 to 923, a total drop of 32%and the lowest IgG ever, suggesting that the M-Spike drop is not only genuine but perhaps even understated. Celebration is in order. CC-4047 is an experimental drug by Celgene, an analog of Thalidomide and Revlimid but hopefully more potent and with fewer side effects. Exactly a year ago I started on the Mayo trial of the drug combination CC-4047 with dexamethasone (DEX). M-Spike dropped dramatically from 2.7 g/dL down to a low of 0.9 g/dL last October, the best value in mo... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=2241633 Fri, 06 Mar 2009 15:30:00 +0100 2241633 http://www.medworm.com/index.php?rid=2168172&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2009%2F02%2Fplateau-continued.html Mayo Clinic Visit Thursday, February 5, 2009, Cycle 12: Good News! M-Spike went down from 1.1 to 1.0 g/dL and IgG from 1350 to 1160 mg/dL. Together, these results seem to indicate an actual drop in tumor burden of perhaps 10% or so. Maybe not, because test results can vary, but most likely the cancer is down. We celebrated last night. I do wonder WHY it's down, though. I'm still taking CC-4047 2 mg daily and dexamethasone (DEX) 8 mg once weekly. What else was different in this last month? Or was it the previous month that was different, when it seemed to go up? I dunno. Anyway we'll take it! Thanks to Celgene for CC-4047, Mayo Clinic for excellence in medicine, and specifically to Doctors L and KDS. Other test results were mostly good too, and in fact mostly unchanged. Light chains are... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=2168172 Sat, 07 Feb 2009 17:11:00 +0100 2168172 http://www.medworm.com/index.php?rid=2168173&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2009%2F02%2Fplateau.html Quick update: I visited Mayo Clinic yesterday (Thursday) at the end of my 12th cycle on the trial drug CC-4047 with dexamethasone. Bottom line: M-Spike went down from 1.1 to 1.0 g/dL. In addition, IgG dropped from 1350 to 1160 mg/dL, strongly suggesting that the decrease is real and not just a testing anomaly. The doctor used the work "plateau," and pointed out that the M-Spike hasn't really increased since last August, when it was lower than it had been in the previous three years. She even referred to the possible management of myeloma as a chronic illness rather than a fatal one, though we agreed that we don't yet know if that is appropriate in my case. More information coming soon, in exhausting detail as always :-) (Source: Myeloma Hope) Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=2168173 Fri, 06 Feb 2009 18:19:00 +0100 2168173 http://www.medworm.com/index.php?rid=2098193&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2009%2F01%2Fcc-4047-cycle-eleven.html Mayo Clinic Visit, January 8, 2009: After eleven cycles of the trial drug CC-4047 and dexamethasone (DEX) my tumor burden may be starting to go up again. Last month's M-Spike was 1.0 g/dL and this month's is 1.1. The test-result printout, however, says "no significant change." And I suppose that's right. It's possible to read too much into one set of blood tests, and the accuracy of this test may not be much better than 10% anyway. But previous tests and the results of other markers do suggest that the myeloma is coming back, if slowly. I hope not, but it seems most likely. In particular, IgG increased from 1260 to 1350, the third modest increase in the last three cycles. In contrast, though, Lambda Light Chains went down from 4.03 to 3.31 mg/dL, which might mean something, might not. Th... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=2098193 Tue, 13 Jan 2009 02:00:00 +0100 2098193 http://www.medworm.com/index.php?rid=2040532&cid=t_146640_136_f&fid=36162&url=http%3A%2F%2Fmyelomablog.com%2F2008%2F12%2F15%2Fexciting-multiple-myeloma-data-at-ash%2F This is from a reader. Subject: Exciting Multiple Myeloma Data at ASH Message: Hi Beth, Here are some data highlights from The 50th Annual American Society of Hematology (ASH) Meeting this week: Updated results from the ECOG study evaluating Revlimid plus low-dose dexamethasone in newly diagnosed patients was presented by Dr. Rajkumar in a joint symposium of the American Society of Clinical Oncology and ASH.  The results are the highest 3 year overall survival rates ever reported in this patient group. Data presented by Dr. San Miguel showed that relapsed/refractory patients who received continuous treatment with Revlimid and dexamethasone after achieving their best response lived longer and had increased time to disease progression compared to those who discontinued treatment after ten ... beth's myeloma blog blogs http://www.medworm.com/rss/comments.php?id=2040532 Tue, 16 Dec 2008 01:06:46 +0100 2040532 http://www.medworm.com/index.php?rid=2035633&cid=t_146640_87_f&fid=34935&url=http%3A%2F%2Fmedicine.com.my%2Fwp%2F%3Fp%3D5588 from the Malaysian Medical Resources Vitamin C and E Supplements Do Not Reduce Prostate Cancer Risk, Dexamethasone Increases Post-Op Bleeding Risk in Children, Women More Likely to Die From Serious Heart Attack Than Men (Source: Malaysian Medical Resources) Malaysian Medical Resources blogs http://www.medworm.com/rss/comments.php?id=2035633 Sun, 14 Dec 2008 05:00:00 +0100 2035633 http://www.medworm.com/index.php?rid=2033899&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2008%2F12%2Fstable-with-caution.html December 11, 2008: My myeloma is stable after Cycle 10 of the CC-4047/Dexamethasone trial. Cool. But watch out for elevated liver enzymes AST and ALT. This particular 28-day cycle may have been affected by several unusual circumstances: First, I really did take the supplements almost every day; I got a flu shot in mid-November; We enjoyed two days of Thanksgiving partying; Three weeks ago I pulled a band-aid off the back of my hand and unknowingly lifted the skin right off with it, leaving a large open sore; That sore developed a large (ugly) scab; Which does not look infected, but is healing very slowly; I got a 24-hour flu or food poisoning nine days before the Mayo appointment, including stomach upset and a slight fever, with a complete recovery by the next morning; and Something, who... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=2033899 Fri, 12 Dec 2008 20:15:00 +0100 2033899 http://www.medworm.com/index.php?rid=1964472&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2008%2F11%2Fnaughty-don.html Perhaps the new CC-4047 drug has done the best it can. After nine four-week cycles in the phase-II trial, overall results are good but numbers are no longer improving. M-spike actually went up slightly this month for the first time, from 0.9 to 0.97, though still well down from the high of 2.7 at the start of the trial. This is also the first time that I have seen M-spike reported to the hundredths digit, though, so I wonder how significant that last digit really is, knowing that the electrophoresis test which measures M-spike isn't especially accurate anyway. IgG is virtually unchanged, and Lambda free-light chains (FLC) are up a little but so are Kappa light chains, and the ratio is unchanged. White cell and red cell counts are mostly unchanged, also good. Hemoglobin is actually up a li... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=1964472 Sun, 16 Nov 2008 21:59:00 +0100 1964472 http://www.medworm.com/index.php?rid=1888582&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2008%2F10%2Fgood-news-again.html October 16, 2008: Eight four-week cycles of the phase-II trial of the new Celgene drug CC-4047 are now complete, and overall results are great. M-spike dropped again this month from 1.0 to 0.9, just a third of the high of 2.7 at the start of the trial. YAY! IgG is virtually unchanged, and Lambda free-light chains (FLC) are up a little but so are Kappa chains, and the ratio is actually a bit higher (better). White cell and red cell counts are mostly unchanged, also good. Blood pressure, which was about 150/80 two months ago, was down to about 122/58 this month, probably because Dr. L has reduced my dosage of dexamethasone (dex) from 20 mg once weekly to 12 mg. That 12-mg dosage will continue for the ongoing ninth cycle. The entire protocol as prescribed by Dr. L is detailed in a previous ... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=1888582 Sun, 19 Oct 2008 00:59:00 +0100 1888582 http://www.medworm.com/index.php?rid=1556571&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2008%2F06%2Fdiabetic-for-day.html Or two. DEX makes us temporarily diabetic by messing with the glucose transport system, which decreases the body's normal ability to move glucose out of the blood and into muscles and other organs. I have a blood glucose monitor and did a simple study of my own blood glucose, taking a reading every half hour or so all day long, on four different sore-fingered days. Here is the bottom line result, where Day 1 is the next day after taking the DEX the previous evening. The "glucose" value is an average for the whole day, expressed in mg/dL: Day  Dose mg  Glucose   Comment 1 40 144   Highest was 193 2 40 101 5 40 88   DEX effect must be gone 1 20 116 More information about this little personal "study" is detailed in earlier blog posts HERE and HERE. Graphics in... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=1556571 Tue, 01 Jul 2008 01:08:00 +0100 1556571 http://www.medworm.com/index.php?rid=1478335&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2008%2F05%2Fcc-4047-rocks-again.html Three months ago I enrolled in a phase-2 trial (study) of Celgene's new IMiD drug CC-4047, with once-weekly dexamethasone. This third cycle brought another good result. My two primary markers, IgG and M-spike, are both down more than 50% after three months. This is an excellent response, especially since I stopped responding last year to thalidomide, a relative of CC-4047. I know that other patients have done well too. CC-4047 is not a cure for myeloma, but it may become a very important tool in managing it and an actual lifesaver for some who have exhausted other options. I hope it becomes more widely available SOON. CC-4047 side effects for me: Bradycardia - my resting heart rate has dropped from about 48 to about 41. Slight reduction in red cell count and hemoglobin, taking both just b... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=1478335 Fri, 30 May 2008 01:48:00 +0100 1478335 http://www.medworm.com/index.php?rid=1461340&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2008%2F05%2Fdex-and-blood-sugar-part-3.html In early April I did a little experiment, measuring my blood glucose approximately every half hour on three different days: (1) Dex day (after taking dex the night before), (2) the next day, and (3) the fifth day (hopefully no dex). Results are here. I didn't like that much dex for several reasons, and when I showed the shart to Dr. L she reduced my dex dosage from 40 mg to 20 mg. This week I did the measurements again for "dex day," and found the glucose levels significantly lower, as expected. Here are averages for each of three different days: Dex   Glucose mg/dL 40 mg   144.3 20 mg   115.8 None   88.2 Bottom line: 20 mg of dex puts the average glucose approximately midway between 40 mg of dex and no dex. Huh - no surprise. Here is a TABLE showing actual measur... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=1461340 Thu, 22 May 2008 15:25:00 +0100 1461340 http://www.medworm.com/index.php?rid=1337102&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2008%2F03%2Fdex-and-blood-sugar-part-1.html We myelomiacs are all aware that dexamethasone (dex) can cause type II diabetes, sometimes permanent and sometimes reversible after discontinuing dex. This is most common among people who have taken "high-dose" dex, typically 40 mg per day four days on and four off. I am taking "low-dose" dex, 40 mg once a week, Friday night before I go to bed. Nevertheless I already have a blood glucose monitor which I bought for another reason (not diabetes) and wanted to see what happens to my own blood sugar when I take dex. I decided to take a measurement about every half hour between waking and bedtime on three days: (1) Saturday, the day after taking dex, also called "buzz" day; (2) Sunday, "recovery" day; and (3) Wednesday, the fifth day, when effects from dex should be minimal. The graph will be... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=1337102 Sun, 30 Mar 2008 17:13:00 +0100 1337102 http://www.medworm.com/index.php?rid=1289344&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2008%2F03%2Fmayo-wrapup.html Four trips to Mayo, 680 miles, and oh so worth it. Today's dex headline: I had a little trouble sleeping last night, awakened early and laid there with my brain buzzing most of the time. Otherwise the Sunday morning after Friday night's dexamethasone (dex) is uneventful. I feel fine, and not so hopped-up as yesterday. Analysis of test results: Here is a little table of some of the important results, with the "bad" ones first, then the "good": Test & units Dec 26  Mar 7   Comments M-Spike g/dL 2.05 2.70   I don't quite believe it, see below BMB Plasma cells % 6.7 5-10   Another result showed 22% - ?? Calcium mg/dL 10.0 10.2   Above Mayo normal range of 10.1 FreeLite mg/dL 4.67 5.88   Gives credence to the M-Spike PET Scan   Pos   Showed up VERY ... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=1289344 Sun, 09 Mar 2008 19:14:00 +0100 1289344 http://www.medworm.com/index.php?rid=1288689&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2008%2F03%2Fso-whats-all-fuss.html I'm sure that I will find out! But so far, the first morning after the first dose of CC-4047 2 mg and dexamethasone (dex) 40 mg, I feel quite normal. I was a little restless toward morning, but that's not unusual, and not surprising in these circumstances. I got back to sleep and awoke refreshed. Are my thighs a little tired feeling, or am I imagining that? Time will tell. This is Saturday morning, so normally I would be running with the St Croix Valley Runners right about now, but it's six degrees BELOW zero and I have wimped out! I'll run on the indoor track at "the club" later today, with my sweeties. That will be an interesting test. Yesterday's visit to Mayo was uneventful, really. No more holes poked in me. We did a lot of talking and I picked up the CC-4047 and dex. A few things g... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=1288689 Sat, 08 Mar 2008 13:47:00 +0100 1288689 http://www.medworm.com/index.php?rid=1131312&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2008%2F01%2Fhumpf.html Disappointing Test Results. Last October my new "everything including the kitchen sink" self-treatment regimen seemed to be producing results, with a significant reduction in IgG from September to October, and a slight reduction in "spike." Yesterday I received the results from the last nine weeks on the regimen, and those results are not as encouraging: IgG up 11.5% to 3000 mg/dL, near the high September level, SPEP monoclonal protein (SPEP) is up 11% to 2.05 g/dL, an all-time high, and For the first time ever, slight amounts of lambda light chains were found in my urine. I hoped and almost expected those numbers to go down, not up, so this is a disappointment. However, the news is not all bad. I have a beer here, but I'm not crying in it :-) Calcium remains low, as does creatinine, bo... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=1131312 Fri, 04 Jan 2008 17:09:00 +0100 1131312 http://www.medworm.com/index.php?rid=1020091&cid=t_146640_136_f&fid=36051&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FCancerCommentary%2F%7E3%2F183396354%2F According to a new study from St. Jude Children’s Research Hospital, the anti-leukemia drug dexamethasone contributes to a relentless fatigue and poor quality of sleep in children undergoing treatment for acute lymphoblastic leukemia (ALL) – thereby suggesting that clinicians could improve the quality of life for these children by developing new methods of drug administration that reduce or eliminate these side effects. Although effective in the treatment of ALL, dexamethasone could also cause a variety of side effects in children, including fatigue. The St. Jude team showed that dexamethasone significantly increased patients?fatigue, length of daytime naps, frequency of awakening at night and the amount of restlessness during sleep. The findings also suggest that before initia... Cancer Commentary blogs http://www.medworm.com/rss/comments.php?id=1020091 Mon, 12 Nov 2007 04:59:47 +0100 1020091 http://www.medworm.com/index.php?rid=864740&cid=t_146640_136_f&fid=36163&url=http%3A%2F%2Fmyelomahope.blogspot.com%2F2007%2F06%2Frethinking-proactive-treatment.html My myeloma is still in a early stage, barely even smoldering. Thankfully, it has not grown rapidly; it seems to double about every 18 months. Nevertheless, I have asked my doctor to be very proactive in two ways: (1) Testing for potential problems, and (2) Treating the disease before symptoms develop. Although studies have shown that early treatment does not result in longer survival, my theory has been that early treatment should at least yield a higher quality of life by delaying symptoms like broken bones and failed kidneys. Mayo clinic, on the other hand, has recently published a new consensus statement outlining a treatment algorithm for newly-diagnosed myeloma patients titled "Treatment of Newly Diagnosed Multiple Myeloma Based on Mayo Stratification of Myeloma and Risk-Adapted Ther... Myeloma Hope blogs http://www.medworm.com/rss/comments.php?id=864740 Tue, 12 Jun 2007 21:16:00 +0100 864740