I got the last of my stem cells today and that took most of the day to get that completed. They tell me that I got a total of 4,700,000 stem cells in all. I will still have about 700,000 stem cells in storage. They tell me it will be 5 to 10 days before the stem cells start rebuilding the bone marrow which is been wiped out by the chemo I got last Wednesday. During the times that I was actually getting the stem cells there was the APN who was responsible for manual infusion of the stem cells, a doctor overseeing the operation, two nurses and a person from the area responsible for storing the stem cells in the liquid nitrogen.
I felt better today than I did last night and I was not running a fever today as I was last night.
They have a program for UAMS myeloma patients staying in these Park Avenue Lofts apartments. They come early and draw the blood before the appointment at UAMS. I have never taken advantage of that program but we will start doing that tomorrow so when we arrive at UAMS/MIRT they should have my blood results already completed and ready to review to see if I need anything. This should save lots of time.
Thank you to all our wonderful friends and family for your support.

Today's update will be brief. I'm not feeling as well as I have been in the past few days. I started running a fever about midday. I have started on an antibiotic now. My platelets ran 23 today and my white count was 1.46. I will get my last bags for the stem cell transplant tomorrow.
It was beautiful weather here today with low humidity and decent temperatures. From what I hear, just like at home. A few days ago the heat index was 110 in this area.

We were at MIRT today about three and a half hours getting blood work done and questions answered. It looks like I will have to get a unit of blood tomorrow since my hemoglobin today was 8.2.
My platelets were down from 34 yesterday to 26 today. My white blood count yesterday was 4.07. Today it's 2.57. It looks as if I'm heading into the time that I will have no immunity and I will have to be very careful.
I have not mentioned how my neck is doing after the surgery with the seven or eight inch incision starting at my skull and going down my back, but it continues to improve with less pain when I move my head up and down and back and forth. I had been concerned that it might retain that pain but it is improving.
Thank you all for all the prayers and support.

I went today and got 3 more bags of stem cells. I will not get any Saturday and Sunday then I will go back Monday and get 3 more bags and that will complete the stem cell transplant. I will have to be it the cancer center Saturday and Sunday but that'll just be for checkups and getting blood work done in any corrections that need to be made. I'm trying to eat foods with potassium in them because if I have to get a transfusion of potassium it takes 10 hours to get that. They can't run it faster than that because it causes heart failure. The process of getting the stem cells went very smoothly today but I was there from 9 a.m. until about 4 p.m. getting that done. I always have to wait afterwards until I complete a bag of saline and today that took about two and a half hours extra. It was causing my heart rate to drop and they had to run it slower.
My lab work showed that my platelets had decreased from 42 yesterday to 34 today I expect lots more decreases in the next few days. They also keep telling me that I will start feeling real bad soon. If I feel bad enough during those days, I probably will not do a blog entry but we'll see how it goes. Some people make it through without this sickness and so forth that they tell me I will have.
I'm so hoping and praying that this chemo treatment that I have received will kill out the myeloma. I know you're praying the same and it's very much appreciated. Thank you all for your support it is needed and appreciated so much.

In the photo above is one bag of my stem cells. I thought you might want to see what they look like. I don't think you can see it in the photo, but the stem cells look kind of grainy in appearance. It took us over three and a half months being down here in 2013 to get these 10 bags.
I failed to post last night what yesterday's platelet count was. It was 48 yesterday, and was 42 today. So that means it's probably started back down due to the chemo I have received. I will not receive any platelets now until it gets down to 10. That is unless I have unexpected bleeding.
I received my first stem cells back today. As you remember, they were collected in early 2013 and kept frozen in liquid nitrogen since then. There is a total of 10 bags of stem cells. I received four of them today. I will receive three of them tomorrow and the other three on Monday. The APN that is assigned to me while I'm getting the stem cells told me today that in the next 3 to 4 days I will start feeling really bad. That will continue until I have recovered. Some people have reactions when they get their stem cells back due to the preservatives that are used with the stem cells. I felt fine all during the time I was getting the stem cells back. It took a couple of hours, and then I had to wait two hours after I got them to make sure I wasn't getting some kind of a reaction. It was interesting, a lady from the place where the stem cells are stored brought one bag at a time and after it was infused, she would bring another bag.
My white count today was 3.74 but it will soon start to go down because of the chemo. They forecast it to get near zero. At that point I won't be able to be around any people except medical people at the infusion area where I go and Reta. They tell me this condition, since I am a slow recovery person, could last a couple of weeks or more.
Thank you all for the nice comments and other communications to us. They are very much appreciated. It lets us know you're going through this with us and that means a lot. Thank you!

I received the dose of melphalan today. I have had no side effects so far but they predicted that the side effects would start in the next few days. They told me the infusion of the chemo would take about 20 minutes so I had predicted to myself that we should be in and out fairly quickly today even though I knew I would have to get a unit of blood. It ended up that I had to get two units of blood and a bag of magnesium. We got there at 8:45 this morning and did not leave until 5 p.m.
It was Reta's birthday today so after we finished, I took her out to eat somewhere that she wanted to go.
Please don't forget to include in your prayers that the chemo I received today will wipe out the myeloma without causing life-threatening side effects. Thank you for your prayers and your comments on the blog.

I saw doctor Van Rhee today and I will explain as best I can what he explained to me. He had the images for the PET scan that was done yesterday. He explained that even though the myeloma markers had gotten better the images when compared to the June 7th images were worse now. I could easily see for myself the images were worse now than they were when we came in early June. Since I have gotten the vdt pace, it should have improved the situation greatly but it had not. The scan showed hot spots all over my body. There are doubts now the high powered melphalan will reduce the myeloma as it should. He said to keep a positive attitude and hope for the best. I will continue on with the stem cell transplant as I had planned before. As I write this we're waiting to get the central line installed so that they can give me infusions of my stem cells. We have waited here for over 3 hours and still have not gotten anything accomplished. I thought I would use this time waiting to catch up on the blog.
My platelet count had gained to 30 today from 29 yesterday. I have mentioned in the blog about my Kappa free light chains going down to about 7 after I got the vdt pace. They have steadily increased to 10 and then 20 and today they were 44. These big increases have been in a short amount of time. This is really not good.
As you can see I really need your prayers in order to stop this awful disease. Thank you.

My platelet count had gone to 29 today from 28 yesterday.
My schedule called for me to get 4 MRIs today with the last one starting at 9:30 tonight. When I went in at 8 a.m to get one of the MRIs this morning, the lady told me that she was going to try to do all four while I was there this morning. She managed to do that and I was so glad that we didn't have to go back tonight. I got the 4 MRIs , blood work and the PET/CT scan this afternoon.
Tomorrow I will have to see Doctor Van Rhee and I will also have to get a CVL line put in. That's also called a central line. The last one of those I got put in, they put it in my neck and I really didn't like getting it put in. Maybe tomorrow will be a more pleasant experience getting it put in.
Just a reminder that Wednesday is when I will be getting the melphalan infusion. They told me today that it would be about 10 days after they are given to me before the stem cells start to make any difference.
Don't get overheated in the hot weather.

We had to go get my blood work done today and my platelet count had gone up from 23 two days ago to 28 today. Of course we were so glad that it was going up.
I have found out that the chemo infusion will last about 30 minutes. I have been told that I won't feel any effects for a few days and then they will be pretty bad. I will have to say I really dread going through this, especially with the risk involved in recovery that I mentioned in an earlier posting.
Tomorrow, my testing starts at 8 a.m.and then we have some big breaks between tests with the last one starting at 9:30 p.m.
I hope everyone has a wonderful Monday.

We didn't have to go to UAMS today so we spent the day relaxing and getting caught up on doing nothing except what we wanted to do. We did watch several episodes of Gunsmoke that was filmed in 1957. We both really enjoy watching Gunsmoke.
The only thing we have tomorrow is to go for Labs at 1 pm. I will be hoping that my platelet counts have gone up from the test yesterday.
I hope everyone's having a really good weekend and staying out of the heat.

The only thing we had to do today as for anything medical was to go and get my blood drawn and tested. After it was drawn and after there was enough time for it to be tested the nurse came back and told me that the platelet count was 13. We were very disappointed and I was also concerned because two days ago it had been 21. I was trying to think what's going to happen now with such a big drop in just two days and how that's going to affect things. How can I possibly recover from a much stronger chemo when I'm not recovering from the past one which is been almost a month ago. The nurse came back into the room and said she had looked at the results wrong instead of being 13 my count was 23. Well we were overjoyed and so relieved. The count did not go up much but it did go up and not go down. This shows I am recovering!
The APN that we saw today is giving us another day off tomorrow so we don't have to go back until Sunday. The extra day off will sure feel good.
Thank you all for the comments. Joanie, my address here is:
Jerry Caldwell
Park Avenue Lofts
Apartment 3113
320 South University Ave
Little Rock, AR
72205

We did not have to go to UAMS today so we took the opportunity to get stocked up on supplies that we will need while we're living in the apartment. It was really hot here today but I won't complain because I know it was really hot there in Northeast Tennessee too. They are forecasting it to get to 97 here tomorrow.
I got my schedule for testing next week and it looks like I'm going to have a very heavy schedule on Monday. My first one starts at 8 in the morning and my last one starts at 9:30 that night.
I won't have any counts to report today so I will report them tomorrow night after I get the tests done. I hope everyone has a nice evening. Thank you all for the real nice comments you left. They are much appreciated.

Today was kind of an uneventful day which feels so good at this time the way things have been the last few weeks. Map platelet count yesterday was twenty-three and today's check was 21. I hope that means they're kind of holding their own and maybe they will soon start to go up. I don't have to go back to MIRT tomorrow. I get to take that day off but then we will have to go back Saturday and Sunday. Let me explain again what MIRT stands for in case you missed an explanation I made several blogs ago. It stands for Myeloma Institute for Research and Therapy which is part of UAMS. UAMS is University of Arkansas for Medical Sciences.
I had to get an IV of magnesium today which increased my stay there for another 2 hours.
Thank you all for the really nice and wonderful comments you made. They are very uplifting. Reta appreciates them too.

You can see in the photos above the difference in our sleeping facilities in the hospital and our sleeping facilities here. I am very thankful for the hospital but I am so glad to get out after 38 days being in there.
I learned quite a bit about the future plans from Dr. Van Rhee today. He told me that my bone marrow biopsy I had in early June showed 80% myeloma involvement in my bone marrow. The one I had last week showed only 5% involvement. The four days of chemo made that much difference but it is short lived because the myeloma will come back as strong as it was before if further treatment does not proceed.
One week from tomorrow, on Wednesday next week, he plans to start a stem cell transplant. I will receive a 45-minute infusion of melphalan and 18 hours after that, I will start to receive my own stem cells back in order to rebuild my bone marrow that the melphalan has wiped out. I will receive the five million stem cells, that I have stored from 2013, over a period of several days. There is risk involved since I have a low number of stem cells stored and he said the quality of the ones stored are probably low quality. He predicts a very slow recovery time as for as me producing platelets and also I will never be able to produce platelets like I once could. That will restrict what treatments they can use to control the myeloma since most treatments cause lower platelet production. He said I would have very low white cell count for about 2 weeks after the melphalan infusion and I would have to be very careful not to contact infection. He thinks the recovery will take around eight weeks. It looks like we're going to be here for a while. As I find out more, I will post more information on the blog about it.
I really appreciate all your notes, comments and emails. You all make this whole thing a lot easier.

My white count had increased to 3.32 this morning. I won't post results of the white count again unless there's a big change in them. My platelets changed from 16 yesterday to 15 today so I'm hoping that means that I am holding my own on platelets. Maybe they will soon start to go up on their own but I did receive a bag of platelets today and one unit of blood.
It seemed as if we were never going to get out of the hospital today and be released. They had to remove the PICC line late this afternoon that was not as easy as I had hoped. The device has something to hold it in that resembles a hook on each side of it. When they started to remove it, the hooks would not release from the flesh inside my arm. The nurse worked on it awhile and each time he pulled, it created quite a bit of pain. He gave up and called another nurse and she had the same problem and finally she gave up and called a doctor. He came and pulled and tugged and each time the pull and tug caused even more pain so he gave up and called a surgeon. The surgeon gave me several injections of Lidocaine around the site of the PICC line and pulled it out and that finally worked. Thank goodness!
We finally got to the apartment and it is lovely, and quiet and just wonderful to be here. I have to go back to MIRT in the morning at 9 and then I have an appointment with Dr. Van Rhee.
I'm sorry I'm so late posting this but we have been running so behind this afternoon.

My white count increased today from 3.06 (yesterday ) to 3.32. I probably will not get a growth factor shot tonight to stimulate production of white blood cells. I have been getting the growth factor shots to increase my white count. My platelet count was down again today to 16. They have been trying to keep it above 20. If it is not higher tomorrow, I will be getting another bag and possibly two bags of platelets. I'll be closely watching my platelet count in the next several days and hoping the count is going to go up.
We met a nice Mennonite family here today who have a daughter here that has leukemia. They live about 170 miles from here and there must have been about 30 of them, including kids, here to visit the one in the hospital. It really reminded me of being around the Amish when we go there. We enjoyed talking with them.
I hope you have a good start to a new week.

This is our 36th day in the hospital.
My white count went from 2.32 yesterday to 3.06 today. I will get my last growth factor shot tonight so the white count is forecast to drop some after these injections stop before it continues to go up. It actually could be at a maximum at this point, I guess. I did not get platelets today. They will see if I can hold my own on my platelet count or if they will go down again. Of course I am hoping that it will hold or go up in the count.
This was my first day to get out among other people without a mask on. We even walked downstairs and went out to the parking garage to take a couple of items. I still expect that we will be released to go to the apartment on Monday.
Thanks very much for both of your comments on yesterday's posting. They are much appreciated.

My white count went from 1.76 yesterday to 2.32 today. I will soon stop taking the growth factor shots so the white count will drop but I don't know how much. I got a large bag of platelets this morning.
I got the sedated bone marrow biopsy today without any problems. One of the nurses there is from England and we got to know her from back in 2013 when she worked in the infusion area. It was good to see her again. She was always real good to me and still is.
Thank you all for your comments and support. I sure appreciate it. Joanie, to answer your questions... just include us in your prayers and that all goes well with the stem cell transplant and it's successful afterwards... donor stem cells are sometimes used from siblings, but there are often serious problems when doing that. The most successful is when a person uses their own stem cells for the transplant.
The doctor told us today we would be leaving the hospital Monday or possibly Tuesday. We have been able to get an apartment from the church ministry "Home Away from Home" as we have often in the past. I will still have to continue to come to UAMS for platelets and other reasons.
I hope everyone has a wonderful weekend.

Today was a very busy and sometimes hectic day. During breakfast, we had two doctors and two APNs in the room at one time. One of the doctors was Van Rhee. He told us he plans on doing a stem cell transplant in about 2 weeks. He has some concerns about it which gives me concerns also. The main thing that he is concerned about is developing into MDS. MDS is deadly. Since I had a poor stem cell harvest, it would tend to create a situation where MDS could happen. He does not think the chance of that happening would be greater than 10%. He said at this point we don't have a lot of options. He thinks there'll be about a 4-week recovery after the transplant. He said my numbers would be very slow in coming back up due to the way my bone marrow recovers. In preparation for the stem cell transplant I will have to have a whole new round of testing similar to what I have when I come to Little Rock each time. Today I went for an echocardiogram and a pulmonary test just to see if I can make it through the stem cell transplant okay. Tomorrow I go for a bone marrow biopsy. The remainder of the tests will be done next week. Thank you all for your prayers. I appreciate them more than I can say. I hope you will continue to pray as we both will need them.
The last few days I've noticed the temperature going up at home inside the house. It has continued to go up even though the heat pump indicates it is running. I called Custom heat and air conditioning today and had them come out and check it and they found the compressor has gone bad. I don't know why things like that happen when you're away from home but it seems like that's the way it happens. At this point, I plan on getting them to repair it even though we are not home.
My white count went from 1.25 to 1.76 today. I will go off the growth factor shots soon and when I do, the doctor said they will drop again but that is normal.
Joy, thank you for the nice comment. I agree with you growing up back then has a lot of good memories.
I hope everyone has good days ahead.

I got 2 bags of platelets today.

My white blood cell count increased today from 1.09 yesterday to 1.25 today. My hemoglobin and red cell count is also increasing.
I don't have anything new to report today. I didn't see a doctor other than the hospital doctor but tomorrow I should be seeing doctor Van Rhee.
That is all I have to report today. It's been a pretty calm day. I hope you are enjoying whatever you're doing and looking forward to tomorrow.

My white count went from .79 yesterday to 1.09 today. My platelet count yesterday, after I got the bag of platelets, was 30 and this morning it was 22. I hope that means they're holding somewhat on their own. I think in the last several days they would have dropped more. For example yesterday, before I got the bag of platelets, the count was 12. I might be just too hopeful at this point. They assure me that it will soon be going up if not now.
Dr. Van Rhee's two APNs came by and filled me in more on their thinking as to what Van Rhee might decide. They are thinking I will be discharged by this weekend. We would then be here for about 2 weeks and then possibly have a stem cell transplant. I have no idea how long that would take but recovery would be the longest part of the process. I know the stem cell transplant would be risky, but at this point I think that would be the way to go if the doctor recommends it. They were very pleased with the way my body had responded to the chemo and recovered well so far. I have been very blessed to not have had very many side effects. I've heard stories of people really having a rough time.
This is a good time for me to say again how much I appreciate your prayers. I think each of you for your support. It has really meant a lot to us both.
I told the APNs that I felt better now than I had felt in a long time. They said myeloma produces something in your body that flu produces when you have the flu. With my myeloma reduced right now, I am feeling better.
Thank each of you for your comments.

I received another bag of platelets today and one unit of blood. My body, of course, is still not producing enough platelets to keep up.
My white count went from 0.56 yesterday to 0.79 today. Of course, I was very glad to see that increase. The best news I got today was from my myeloma markers test which are done on Mondays and Wednesdays. The Kappa free light chains went from 8.60 last Wednesday to 7.07 today. They should not exceed 1.94. I had feared that they would actually go up and the doctor on the weekend prepared me to see a result where they did increase but I am very thankful that it actually went down. Of course this past chemo was just to get the myeloma knocked down to where it can be managed in some way and will come back as bad as it was if nothing else is done. The weekend doctor told me that I may need to have a bone marrow biopsy just to check to see if the myeloma has actually decreased or has only decreased the markers.
I am very thankful for all the prayers that have gone out asking God for my healing.

Today was the 31st day in the hospital.

We had a wonderful visit today with my brother from Memphis and my niece. They are in the photo above. I really hated to see them leave.
My white count went from .34 yesterday to .54 today. I had to get another bag of platelets today so I am still not producing platelets which is expected right now.
Thank you for your nice comments. I hope you have a nice beginning to a new week.

I received one bag of platelets today and one unit of blood. My white count went from .24 yesterday to .34 today.
I am so hopeful that my platelets will soon start to recover. In case I didn't mention it in a previous post, that is an indication of how well the bone marrow is recovering from the chemo. It must recover before I can go on to the next step. At this point, it looks like the next step would be a stem cell transplant.
My hair was coming out from the after effects of the chemo so we cut it all off last night.
Thanks for leaving the nice comments.

The photo above shows the work that Dr. Pait did on my neck. They tell me it will not set off metal detectors and it'll be okay to have an MRI with it.
My white count went from .12 yesterday to .24 today. It looks like it's on the increase now and I hope the platelets will increase too but they tell me that's the last thing to recover. The doctor said today it will probably take a week or two for the platelets to recover. I meant to post yesterday that I got a bag of platelets yesterday and a unit of blood the day before.
A big happy birthday to our good friend, Kathy Dean, who regularly reads this blog and often leaves comments.
I guess that will be all for today. I hope you're having a real nice day.

My white count went from .06 yesterday to .12 today. Maybe now it will continue to increase.
The oncologist that is seeing Dr. Van Rhee's patients stopped by today and was very pleased at how my myeloma markers have come down. He said this past treatment of chemo will probably work another two months. I hope he is right.
I continue to have digestive tract issues from the chemo. I have no idea how long that's going to last. Today I saw my first sign that my hair is starting to come out. I will probably cut it all off tomorrow. I have not felt as well today as I have the past several days. It could be because of sleep they came in at 3:45 this morning to draw the blood. They have not been doing it that early before.
I hope everyone is having a nice day.

This is the 26th day in the hospital.

I thought I would do this blog post earlier today even though there might be something happening between now and bedtime since I had good news to pass on.
Both of Dr. Van Rhee's APNs came in this afternoon and brought the latest results of my myeloma markers. They were very pleased that my Kappa free light chains had improved greatly. Of course I was too. I had been very concerned. The test on Monday was over 16 and today it was only over 8, normal is about 2. In the photo of the plot they brought me, you can see how high the Kappa free light chains got before I got this latest chemo. This chart goes back to August of 2013. I had feared that this chemo, which I've had two times before, would not bring the counts down and I am so very thankful that it has worked. In April of 2013 and in November 2013 I got it which was part of the stem cell collection process.
The information that I had received about when Dr. Van Rhee is going to return has been incorrect. The hospitalist told me he was going to return on Wednesday but it is not this Wednesday but a week from now. The APNs predicted that I would be in the hospital for another week or two. I won't get to leave until I'm making platelets again. I received one bag of platelets today and one unit of blood.
I expected my white count to take a big jump up today but it didn't it actually went back down to 0.06. The APN said it was normal for it to vary this much before it starts up. She also said it wasn't as important for the white count to go up as it was the platelets. They can do more to control the white count by giving me the growth factor shots.
Thank you for the comments. They are much appreciated. I hope you have a nice evening.

Thank you all for your comments. It's always good to hear from you and a bright spot in our day.
I still have some lasting effects from the chemo. That was expected though. My counts went up today. They went from .07 yesterday to .11 today. The doctor said this morning that she expects large gains in the next couple of days. I'm not sure when or even if I will lose my hair this time. My plan is to cut it off before the main part of it comes out but I fear that if I cut it off partly, I would then have a poor haircut. Then, if I did not lose it I would be in a mess. I guess it will all work out. I expect to see my oncologist on Thursday.
I hope you had a nice holiday.

I'm still having some after effects of the chemo. I think that will go away in the next few days. My white count did go up a small amount today but I was very glad to see it because it did go up instead of continuing to go down. It went from 0.05 yesterday to 0.07 today. The best news I had today was that the Kappa free light chains went down considerably from the test this morning. The Kappa free light chains is one of the major things they look at when they look at the myeloma markers. On June 28th my Kappa free light chains was 58.91 and this morning it was 16.17. Normal would be not to exceed 1.94. On one check since I've been here when I was without any treatment at all it was 84+. You could see why I was so glad with the number that I got today. I was so concerned that this round of chemo that I just had would not work and I'm so thankful that it is. Thank each of you for your prayers. It really seems like we're all in this together. I am very thankful for each of you.
I hope you enjoy the holiday.

Thanks for the caring comments that were left on yesterday's post. I really appreciate hearing from you.

I made an error in posting my white count the last couple of days and got the decimal point in the wrong place. I have used the computer and made a correction and it is now correct. The reason I mentioned that is in looking at the results of the past two days it looks like my results would have gone up based on today's results which they did not. The white count continued to go down. Yesterday it was 0.20 and today it was 0.05 which would be 1/4 of what it was yesterday. Maybe soon it will start to recover.

The only chemo after effects I've had today have been digestive tract issues.

When we first got here I had a hospital Tech that was a young black man that seemed to be real caring and we hit it off real well. During that first day he asked us if we knew Jesus. He has come by to see us even though he might be working in another location. Today was his off day and he came in to visit. He's 23 years old and one of the reasons he wanted to come in today was to have prayer with us.
That is all for today thanks for reading.

We had family come from Memphis today to visit. It sure was great to see them. In the photo above is Kim, Val, and Joe. I really hated to see them leave.
The weekend hospitalist came by and had quite a bit of information to share since she had talked to doctor Van Rhee's APN and the APN had talked with doctor Van Rhee. My white count this morning was 0.20. That is less than half what it was yesterday. She said that she expects the white count not to bottom out for 2 more days and then start to increase. She also expects the myeloma markers to improve over the next week. I sure hope she's right. She said that Dr. Van Rhee has a plan at this point to give melphalan and then stem cells which amounts to a smaller than usual stem cell transplant. That is scary to me since it could result in a worse disease called MDS but we will see what the doctor thinks after this.
That is all I have to report today that I can think of right now. I hope you have a good Fourth of July holiday.