Only a few hours after the last post,  we got a call from Jim's doctor,  asking that we return Jim to BI.  He had only been home long enough for a night's sleep, when we tooling along the Jamaica Way toward the hospital.   They promptly readmitted him, once it was established that his oxygen level was quite low, and he remains there for the immediate future.  The bottom portion of both lungs have collapsed in concert with the collapse of his ribs and  vertebrae; over-medication to alleviate the pain he is in also encourages shallow breathing.  Even speaking  on the phone is exhausting.  

The GREAT news is that his most recent numbers reveal that the chemotherapy his kicking the myeloma very successfully.  This is excellent news considering that he is still hoping for a Stem Cell Transplant, which can only performed on someone whose numbers are low.  His have gone from a high of 7400 to a current level of 2800, and he began his fourth course of chemo tonight. 

Frankly, I never entirely understood what chemo really consisted of.  It was 'the man behind the curtain,' and although certain drugs were commonly involved (tamoxifen comes to mind)  it is substantially more direct than that, at least in Jim's case.  He is given fluids and certain preparatory meds, (anti-nausea, and now a new one for rebuilding  bone tissue) through a heparin lock. Again through the lock, they inject the actual chemo drug,  Velcade which goes in in under a minute.  Decadron, the partner drug, is taken orally.  And that's it.  Including the taking of vital signs, and a blood draw, and the normal waiting to be seen, we are usually there only about 2 hours.   In a three week period we only have to be there for treatment on four days.  The third week is for recovery from the enormity of the blasts of these borderline toxic  drugs.   

The place isn't depressing at all.  People sit reading magazines much like in a beauty shop while receiving their treatment.  The lady with snacks and lunches passes through giving away goodies.  It's quiet, passive, positive but not in a forced way, and amazingly "normal" considering the miracles that are taking place.      

Irrespective of how Jim's particular experience plays out, one lesson learned here is to take a gentler view of the pharmaceutical companies who arm patients to confront horrible diseases and fight back, head on.  In spite of admitted imperfections, they fund the development, testing, and long vetting process. We owe a huge debt of gratitude to those who have brought us so very far.