The Numbers Racket

2400.

No, that is not my daily caloric intake. Nor the number of times Warren and I have…well, you know. Nor the balance in my bank account.

2400 is my latest IgG Immunoglobulin count, delivered to me this morning by Dr. Mitchell, who is not my regular oncologist, which made this number all the harder to hear.

2400 is not a number I wanted to see. While it is not a horrific number, it is enough of an "uh oh" number that after the doctor calmed me down, he told me which tests he wanted to order immediately to better interpret that number. He wants to know how much of that number is polyclonal (i.e., okay) and how much of that is monoclonal (i.e., BAD)?

That lead to a discussion of finances and costs and self-paying patients, which is me. In the end we focused on the two tests he insisted on and decided the rest can wait. Even the two most important tests are pricey, so there went another itty bitty piece of my peace of mind. Dr. Mitchell talked about bargaining with the hospital on the charges, and while I can appreciate the wisdom of that strategy, I finally looked at him and said "I understand what you are telling me. But I am tired and this takes so much out of me."

(And I was in tears too, which is never a position of strength for me.)

Now there was lots of good news in today's lab results. My IgA and IgM numbers are rock solid, as are my white and red cell counts. If the myeloma is reactivating at a furious rate, those numbers start to get shaky quickly. Those numbers, my level of physical activity, and the fact that my weight is not plummeting, are all positive signs.

All the same, 2400 hit me hard. That's my highest IgG count since February, 2005. Back then, Tim (my regular oncologist), Pat (my wonderful personal physician) and I were celebrating a number in the low 2000s, because the previous count had been 6100.

If Tim had been there today, we would not have been celebrating.

Tim Moore and I go back to November, 2004, when he confirmed what Pat had already discovered: I had multiple myeloma. I can still remember that initial consultation. After discussing what I already knew about my blood work, Tim said that while there was a slim chance otherwise, the blood work was so devastating that he was certain it was multiple myeloma. Despite knowing that was what he was probably going to say, I burst into tears and said an obscenity (not one of the nice ones), then immediately apologized because I didn't know him at all and didn't know if I could say that in front of him.

I could. We bonded immediately and that bond has never been broken.

As the nurses scheduled my tests and next appointment, they kept handing me tissues. I have been with many of them for almost five years now and that made it easier to let my guard down. It also made for a wad of shredded, wet tissues in my pocket by the time they got me scheduled.

Warren was with me today, as he usually is on my oncology days. He walked me to the laboratory; he had appointments he had to keep and I was going to be awhile longer at the hospital. As he kissed me goodbye and said he loved me, his voice broke. There were tears in his beautiful blue eyes.

I hate making my husband cry.

Back in November of 2005, Tim and I discovered that the transplants I had just undergone did not "cure" me. My latest biopsy and blood tests indicated that there was still something going on. Tim said it could be a benign abnormality that I will live with always. Or it could turn back into myeloma again. He then gave me an analogy that has stuck with me ever since.

"April, imagine your blood cells are Russians and we have a picture of them all standing there in Red Square. We know everyone in the picture is Russian. But we can't tell by looking at the photo if they are KGB agents or not."

I am waiting to see if they are KGB agents.

Life goes on though and I am more than ready to move on with my day. Early on after I moved to Cancerland, I decided I could wring my hands and weep all day every day or I could pick up the pieces and make the most of what I had. I have never regretted choosing the latter path.

As I once wrote my friend Larry, who also shares this disease, "screw myeloma." And that's how I feel right now. Screw myeloma. It's today I need to live.