We are international

Martin Boling

Canberra, Australia; boling@bigpond.com.au

1951 / Class of 2000 / Type: MGUS prog. to IgG (Kappa LC) within 3 mo. / Last Update: 8/02

I grew up in Canberra - the "bush capital" of Australia. Canberra seems to be a locus for a statistically anomalous high incidence of Myeloma in Australia. Prior to diagnosis I enjoyed enviable good health and physical fitness. I worked out regularly I the gym and was in better shape than most Aussie males my age. In June 1999 I did a day hike in the mountains with the local Scout troop and even though I was the eldest leader I was able to keep up with the 14- and 15-year-olds, leaving younger leaders and scouts to eat our dust.

I was diagnosed with MGUS at the end of June 1999 following blood tests for a swollen lymph duct in the armpit. By September 1999 I had compression fractures in lumbar spine with associated renal failure, consequential blood pathology revealing that the disease had progressed from indolent to incandescent within two months. IgG was 54. I was almost comatose when I was taken by ambulance to hospital for admission. I woke up with a central line (cannula implanted through the chest wall just below the collar bone) and tubes running every which way.

My treatment is supervised by a haematologist/oncologist in Canberra hospital. My treatment began in hospital and continued monthly with nine courses of VAD with Aredia. During this time I returned to work on a part time basis (although I was taking the week after the chemo away from work altogether to avoid opportunistic infections). After a short course of radiation treatment for a focus of Myeloma in two vertebrae I had Aphaeresis to harvest bone marrow stem cells after ten months of treatment (August 2000). The bone pain from the GCSF was pretty intense but manageable.

An autologous bone marrow transplant in February 2001 went very well and I made close to a record recovery with discharge after just 13 days (Canberra hospital record is 12 days). I had no side effects or infections during the time the BMT re-established. However, I had a brief bout of pneumocystosis in July/August 2001 requiring limited hospitalisation, which has brought about a change in the local protocol to maintain a regimen of high dose antibiotics for six months after a BMT.

From the most recent consultation with the oncologist, the diagnosis is achievement of a stable plateau phase. Latest blood pathology results are as good as can be expected in the circumstances: WCC = 2.6, Hb = 121, Total Neutrophils = 0.99, Lymphocytes = 1.09, IgG = 25.0, Beta2MG = 3.1.

I have been very fortunate to miss most of the side effects from treatment and those have been minor. VAD induced peripheral neuropathy in both hands and feet, though it has since retreated to a residual and almost imperceptible vague tingling in the extremities of the fingers. Treatment continues with monthly Aredia, twice weekly Bactrim (as prophylaxis antibiotic) and thrice weekly Interferon (currently 2.4 million units).

Since the BMT I have returned to work full time. The only remaining side effects are fatigue at the end of the day and some discomfort in my back on the day following the Interferon. I have excellent support from the social work department of the Canberra Hospital and from my employers, the National Health and Medical Research Council in the Commonwealth Department of Health and Ageing. The disease has induced some life-style changes such as giving up gardening and forsaking the gym. I eat heartily and often just trying to maintain a respectable weight.

A relative (my sister's father-in-law) also has MM and was in the same ward at the same time I was admitted (he was having his BMT). Certainly, shared experiences make understanding the disease and treatment much easier (it is just a bit harder on the families when more than one member is affected at the same time with the same disease). I consider my determination to be as fully informed about the disease and my treatment and to be vigorous in consulting with the oncologist (the often touted 'positive attitude) has been a significant help in successfully overcoming MM.

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