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Raw Food Recipe ~ Juice: Romaine, carrot, blueberries, pineapple Video Clips. Duration : 4.10 Mins.
Update and view what is on the menu for Thursday. Even though I have a cold I am still going with green juices. Breakfast was a banana smoothie and I will video it the next time I make it. Just dont feel like it at 5 am! The filling for those peppers is a nut cheese which has: brazil nuts, sprouted sunflower seed & cashews to equal 2 cups juice of one lemon garlic black pepper salt parsley enough water to thin to consistency of cream cheese. Can use for dip, sauce or filling peppers. ~Since adapting the raw food lifestyle 4 months ago, Laura has released 32 pounds. Currently she is 90% raw and still in transition. A medical diagnosis of severe anemia and leukemia prompted the change from a vegetarian diet to a raw food vegan lifestyle. Laura has experienced immense improvement in lab/blood tests as well as in her energy and overall health since switching to raw foods. UPDATE: The anemia is now reversed and cured!!!~
Tags: pineapple, romaine, carrot, blueberry, blueberries, alaska, wild, harvest, wildcraft, support, motivate, motivation, raw, food, foods, recipe, culinary, vegan, vegetarian, vegetable, uncooked, uncook, not, cooked, living, live, life, dehydrate, dehydrator, excalibur, krup, omega, weight, loss, lose, wellness, health, diet, healthy, healthier, cure, reverse, obesity, anemia, leukemia, CLL
Sunday, September 30, 2012
Chris Cleave, author of Gold
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Chris Cleave, author of Gold Video Clips. Duration : 2.63 Mins.
The spectacular new novel by the bestselling and critically acclaimed author of the reader and bookseller favourite, Little Bee. In the tradition of his beloved previous novel, Little Bee, Chris Cleave again gives us an elegant, funny, passionate story about friendship, marriage, parenthood, tragedy, and redemption. This time, the setting is the upcoming London Olympics. Gold is the story of two women, Zoe and Kate, world-class cyclists who have been friends and rivals since their first day of elite training years ago. They have loved, fought, betrayed, forgiven, lost, consoled, triumphed, and grown up together. Now, on the eve of London 2012, their last Olympics, the two must compete for the one remaining spot on their team. In doing so, the women will be tested to their physical, mental and emotional limits. They will confront each other and their own mortality, and be asked to decide: What will you sacrifice for the people you love? www.booklounge.ca
Tags: little bee, cycling, olympics, chris cleave, friendship, leukemia, athletes, parenthood, books, authors, gold
The spectacular new novel by the bestselling and critically acclaimed author of the reader and bookseller favourite, Little Bee. In the tradition of his beloved previous novel, Little Bee, Chris Cleave again gives us an elegant, funny, passionate story about friendship, marriage, parenthood, tragedy, and redemption. This time, the setting is the upcoming London Olympics. Gold is the story of two women, Zoe and Kate, world-class cyclists who have been friends and rivals since their first day of elite training years ago. They have loved, fought, betrayed, forgiven, lost, consoled, triumphed, and grown up together. Now, on the eve of London 2012, their last Olympics, the two must compete for the one remaining spot on their team. In doing so, the women will be tested to their physical, mental and emotional limits. They will confront each other and their own mortality, and be asked to decide: What will you sacrifice for the people you love? www.booklounge.ca
Tags: little bee, cycling, olympics, chris cleave, friendship, leukemia, athletes, parenthood, books, authors, gold
Armored Saint - Chemical Euphoria
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Armored Saint - Chemical Euphoria Tube. Duration : 4.75 Mins.
Unofficial Video. Raising Fear is the third album by American heavy metal band Armored Saint. It was released in 1987 on Chrysalis Records. They recorded the album as a four-piece. Since guitarist Phil Sandoval quit, the band seemingly lost its confidence and the six-month recording session ended up in a mediocre album. After the release Chrysalis dropped the band. This was the last Armored Saint studio album with guitarist Dave Prichard who died of leukemia in 1990 before the next album. * John Bush - vocals * Dave Prichard - guitars * Joey Vera - bass * Gonzo Sandoval - drums Mirror, mirror Is on the shelf Found another way To ruin and waste my health Took to the flame Put the blade away Just cut my lifeline Quickly in half today Chemical euphoria I'm about to crack Mass hysteria Won't get off my back Chemical euphoria I'm about to crack Mass hysteria Speeds my heart attack When it rains it pours And man I'd say Looks like it's time To build an arc today Absorb me to a pleasant void Somewhere temptation Can't link it's hand to destroy Chemical euphoria I'm about to crack Mass hysteria Won't get off my back Chemical euphoria I'm about to crack Mass hysteria Speeds my heart attack The heart attack Addicted and there's no release Addicted won't you help me please Oh how the road bends Off the deep end Mirror, mirror Is on the shelf Can't find satisfaction Til I help myself Took to the flame Put the blade away Here come the lookout What a price to pay Chemical euphoria I'm ...
Keywords: Armored, Saint, Chemical, Euphoria, raising, fear, John, Bush, vocals, Dave, Prichard, guitars, Joey, Vera, bass, Gonzo, Sandoval, drums, Rock Music, heavy, metal, california
Unofficial Video. Raising Fear is the third album by American heavy metal band Armored Saint. It was released in 1987 on Chrysalis Records. They recorded the album as a four-piece. Since guitarist Phil Sandoval quit, the band seemingly lost its confidence and the six-month recording session ended up in a mediocre album. After the release Chrysalis dropped the band. This was the last Armored Saint studio album with guitarist Dave Prichard who died of leukemia in 1990 before the next album. * John Bush - vocals * Dave Prichard - guitars * Joey Vera - bass * Gonzo Sandoval - drums Mirror, mirror Is on the shelf Found another way To ruin and waste my health Took to the flame Put the blade away Just cut my lifeline Quickly in half today Chemical euphoria I'm about to crack Mass hysteria Won't get off my back Chemical euphoria I'm about to crack Mass hysteria Speeds my heart attack When it rains it pours And man I'd say Looks like it's time To build an arc today Absorb me to a pleasant void Somewhere temptation Can't link it's hand to destroy Chemical euphoria I'm about to crack Mass hysteria Won't get off my back Chemical euphoria I'm about to crack Mass hysteria Speeds my heart attack The heart attack Addicted and there's no release Addicted won't you help me please Oh how the road bends Off the deep end Mirror, mirror Is on the shelf Can't find satisfaction Til I help myself Took to the flame Put the blade away Here come the lookout What a price to pay Chemical euphoria I'm ...
Keywords: Armored, Saint, Chemical, Euphoria, raising, fear, John, Bush, vocals, Dave, Prichard, guitars, Joey, Vera, bass, Gonzo, Sandoval, drums, Rock Music, heavy, metal, california
Tribute To Maanvi's Illness
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Tribute To Maanvi's Illness Video Clips. Duration : 3.25 Mins.
I promise the coloring looks really beautiful in HD. ... Leukemia? are u sure cinevistaas? Well, this is the first time i'm seeing one of the main characters have such a illness. As far as i know Leukemia doesn't cure. Lekemia is a type of cancer of the blood or bone marrow. I'm just too exited to see how they are going to perform this illness. Hair faling, blood transformation, marks on her body, basically Leukemia cause multiple organ failure. I off cource don't want her to die, but it will be such a blooper if they didn't kill her. I wished for it to be brain tumor..even though there are risks that she might lose her memory, but still she would be alive. Anyways, this is a simple video dedicated to Nia Sharma. Her perfomance is just amazing so far..the way she faints is just very good..I will love to see some REAL hospital, and medical treatment in the show..lets see what happens
Keywords: Ek, Hazaaron, Mein, Hai, Meri, behna, Nia, Sharma, Kushal, tandon, Krystal, D'Souza, Karan, Tacker, Maanvi, Viraat, Jeevika, Viren, Star, Plus, show, Tribute, To, Maanv's, Illness
I promise the coloring looks really beautiful in HD. ... Leukemia? are u sure cinevistaas? Well, this is the first time i'm seeing one of the main characters have such a illness. As far as i know Leukemia doesn't cure. Lekemia is a type of cancer of the blood or bone marrow. I'm just too exited to see how they are going to perform this illness. Hair faling, blood transformation, marks on her body, basically Leukemia cause multiple organ failure. I off cource don't want her to die, but it will be such a blooper if they didn't kill her. I wished for it to be brain tumor..even though there are risks that she might lose her memory, but still she would be alive. Anyways, this is a simple video dedicated to Nia Sharma. Her perfomance is just amazing so far..the way she faints is just very good..I will love to see some REAL hospital, and medical treatment in the show..lets see what happens
Keywords: Ek, Hazaaron, Mein, Hai, Meri, behna, Nia, Sharma, Kushal, tandon, Krystal, D'Souza, Karan, Tacker, Maanvi, Viraat, Jeevika, Viren, Star, Plus, show, Tribute, To, Maanv's, Illness
Don't Tell Her It's Me 1990 (Trailer)
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Don't Tell Her It's Me 1990 (Trailer) Video Clips. Duration : 2.30 Mins.
Don't Tell Her It's Me (Trailer) Having just won a battle against leukemia cartoonist Gus Kubicek (Guttenberg)is bald, chubby and not to mention lonely his novelist sister Lizzie Potts (Long) tries to set him up with suitable women. Emily Pear (Gertz) is a young and beautiful reporter whose looking for the right man, after a disastrous first meeting with Gus Lizzie takes it upon herself to transform her brother into a hunk of a man. After a new makeover Lizzie gives him a new name not to mention accent he is now known as Lobo a bad boy biker from New Zealand. Emily finds herself in love with him but Gus wonders if she could ever love the man he really is or a fake dream guy. Steve Guttenberg gave a funny yet touchy performance as Gus Kubicek and Lobo while Jamie Gertz adds a nice touch as his love interest 7/10 Stars
Keywords: Movies, Trailer
Don't Tell Her It's Me (Trailer) Having just won a battle against leukemia cartoonist Gus Kubicek (Guttenberg)is bald, chubby and not to mention lonely his novelist sister Lizzie Potts (Long) tries to set him up with suitable women. Emily Pear (Gertz) is a young and beautiful reporter whose looking for the right man, after a disastrous first meeting with Gus Lizzie takes it upon herself to transform her brother into a hunk of a man. After a new makeover Lizzie gives him a new name not to mention accent he is now known as Lobo a bad boy biker from New Zealand. Emily finds herself in love with him but Gus wonders if she could ever love the man he really is or a fake dream guy. Steve Guttenberg gave a funny yet touchy performance as Gus Kubicek and Lobo while Jamie Gertz adds a nice touch as his love interest 7/10 Stars
Keywords: Movies, Trailer
Saturday, September 29, 2012
Disconcerting update from Little Rock...
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With my next post, I had hoped to simply catch up on some interesting things that I am late to report -- like the CureTalk conversation, etc.
But this has been preempted.
I remain in complete remission, but the MRI has not changed. This was, at first, just frustrating...because I know I don't want to stop medicine until those remaining pits have resolved.
Unfortunately, there's more to it. BB was concerned that they haven't gone away. Not only out of principle, but also because they have learned more about genes in the last four years and one of the genes that was expressed in my myeloma is something called MIC and that can cause "sudden and unexpected loss of remission." This is what happened to my friend BB (not the doctor, but with whom I had dinner the other night here) and that BB was low-risk, and suddenly lost remission, and now has high risk disease and a pretty grim diagnosis, though he is fighting and there is always hope.
My disease has the same propensity to do that.
Now the MRI didn't change -- there are still five residual "small" lesions in the spine. They are too small to be aspirated. But the former region in my hip -- which was fully resolved but which Bart says indicates some potentially undesirable marrow characteristics -- is large enough for them to stick a needle in.
So I agreed, provided they are knocking me out. I discussed with BB (the patient, not the doctor ) that FNA doesn't stand for "fine needle aspiration" but rather for "keep that F*@#ing Needle Away from me!" :)
Regardless of outcome, I will continue on Velcade at a higher dose than before. He is okay with me dropping Revlimid because he is concerned about secondary cancers at this point, particularly given my squamous cell carcinoma and the preliminary myelodysplastic cells in my marrow from last time. He is okay with me dropping dex so long as I can tolerate the Velcade. But the Velcade continues. I can get it subcutaneously, so that's something, I suppose.
If the FNA shows something, then I may be looking at another round of the original chemo -- VTD-PACE. Not something I'm looking forward to, but if it's necessary, I'll do it, I guess.
He said he is now taking me off protocol and "going out on a limb" but "we're in this together."
That's not what I wanted to hear. I wanted to hear "the myeloma is gone and will not be coming back."
I have so many concerns, I don't know where to begin, really...among them, will I ever be confident that this is really gone forever? I suppose if all those lesions resolve and the marrow returns to normal, I can be confident.
I'll need to come back here for more testing, almost certainly, at some point in the next few weeks.
My thoughts are scattered...apologies for the incoherent post. Pretty shaken right now.
With my next post, I had hoped to simply catch up on some interesting things that I am late to report -- like the CureTalk conversation, etc.
But this has been preempted.
I remain in complete remission, but the MRI has not changed. This was, at first, just frustrating...because I know I don't want to stop medicine until those remaining pits have resolved.
Unfortunately, there's more to it. BB was concerned that they haven't gone away. Not only out of principle, but also because they have learned more about genes in the last four years and one of the genes that was expressed in my myeloma is something called MIC and that can cause "sudden and unexpected loss of remission." This is what happened to my friend BB (not the doctor, but with whom I had dinner the other night here) and that BB was low-risk, and suddenly lost remission, and now has high risk disease and a pretty grim diagnosis, though he is fighting and there is always hope.
My disease has the same propensity to do that.
Now the MRI didn't change -- there are still five residual "small" lesions in the spine. They are too small to be aspirated. But the former region in my hip -- which was fully resolved but which Bart says indicates some potentially undesirable marrow characteristics -- is large enough for them to stick a needle in.
So I agreed, provided they are knocking me out. I discussed with BB (the patient, not the doctor ) that FNA doesn't stand for "fine needle aspiration" but rather for "keep that F*@#ing Needle Away from me!" :)
Regardless of outcome, I will continue on Velcade at a higher dose than before. He is okay with me dropping Revlimid because he is concerned about secondary cancers at this point, particularly given my squamous cell carcinoma and the preliminary myelodysplastic cells in my marrow from last time. He is okay with me dropping dex so long as I can tolerate the Velcade. But the Velcade continues. I can get it subcutaneously, so that's something, I suppose.
If the FNA shows something, then I may be looking at another round of the original chemo -- VTD-PACE. Not something I'm looking forward to, but if it's necessary, I'll do it, I guess.
He said he is now taking me off protocol and "going out on a limb" but "we're in this together."
That's not what I wanted to hear. I wanted to hear "the myeloma is gone and will not be coming back."
I have so many concerns, I don't know where to begin, really...among them, will I ever be confident that this is really gone forever? I suppose if all those lesions resolve and the marrow returns to normal, I can be confident.
I'll need to come back here for more testing, almost certainly, at some point in the next few weeks.
My thoughts are scattered...apologies for the incoherent post. Pretty shaken right now.
A more thoughtful recap of my current status
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Hello friends.
I've had a couple of days to think through what the current situation is and so I'm going to try to recap it here.
I've finished three years of maintenance therapy. This is supposed to be the "woo-hoo!" moment at UAMS when BB tells me "the Myeloma is gone and will not be coming back" and I can drop all meds except Acyclovir (the anti-viral that keeps Shingles away, which I need to stay on while my immune system recovers, which it would finally be allowed to do since I would be off the meds that suppress it).
Quoting the now 70+ year old BB directly from last week's appointment, "my usual approach is to continue to treat until such time as all the sh*t is outta there, so to speak." This means traditional evidence of complete remission (no M-spike under the most stringent blood tests, normal urine, normal marrow) but also what BB called "Arkansas complete remission" (or MRI complete remission) which also means that all formerly-active lesions in the bones are fully resolved (i.e. replaced / refilled) with new bone, as confirmed under MRI. His hypothesis is that these lesions are microenvironments in which myeloma cells can restart. If the lesions are replaced with bone, it means they won't be able to do so.
We have been watching my 19 formerly active lesions resolve over the last three years of maintenance therapy, and all have gone (so I thought) except for five small ones in my spine, which have shrunk from 2.5cm at baseline (i.e., when I showed up to be treated) to 4 mm as of a 18 months ago. But they have remained stable over these past 18 months. I was hoping to see them gone since in addition to the normal maintenance protocol of Velcade, Revlimid and Dex, I was on the bone-strengthening bisphosphonate agent Zometa, the frequency of which was increased to one infusion per month over the last six months (I think I got four of them, actually -- same difference since this aspect of treatment is far from an exact science).
Last week, the MRI revealed that the five spinal lesions had still not resolved. They were termed "small" and were not sized, but in the summary of results they were considered "stable" relative to the last scan six months ago. This was problem number one. BB wants to continue to treat until such time as...uh...well until such time as these are fully resolved, to use more polite phraseology than was employed in the actual consult. In and of itself, this wouldn't be a huge deal...but this prompts questions about what medicine(s) to continue to take while waiting for resolution, and how effective they will be.
I've been on Velcade, Revlimid and Dexamethasone for three years of maintenance, but readers will know that I've had concerns about continuing on Revlimid. It has been a key agent in maintenance therapy since Total Therapy 3 was begun in around 2003 and is widely used now. About a year ago, it was noticed (by numerous entities, including the company that produces it) that Revlimid was associated with secondary malignancies -- solid cell tumors and leukemia, to be precise. I had a squamous cell carcinoma in my finger, so we can check that box. I had pre-leukemic cells in my marrow six months ago...so before we check that box, BB wants me off this stuff. I agree. For a while, the value of Revlimid (inclusive of these risks) is a no-brainer. But after three years, has it done everything that it should do? Is it now at the point where the risk of continued use is greater than the risk of remission loss? Perhaps. In fact, normally I would be pretty easy to convince except for certain aspects of my current situation.
Then there is the matter of -- for someone looking to continue maintenance with some urgency -- what it can be replaced by. I want to keep up the attack on whatever rogue cells aren't yet with the program and make my body as inhospitable as possible for Myeloma cells while my bones continue to heal. I suggested Pomalidomide, which as many readers know, is the next generation Revlimid. BB said "yeah, good idea, but we can't get it." I believe this is because Pomalidomide is still only available -- even to Arkansas -- as a single agent except perhaps in refractory cases, and I'm thankfully not yet a refractory case. And if we are to use just one agent, BB wants to keep me on Velcade since he believes this is the most effective anti-Myeloma agent there is. He asked me if I can tolerate it without the Dex and I said "sure!" -- mostly because I want off the Dex. So that does seem to indicate that Dex in maintenance is not used for its plasmacytolitic (i.e. killing plasma cells) properties but because it helps counterract the effects of Velcade (flu-like symptoms, GI issues, etc.) I will be increasing the dosage of Velcade from the already high 1.3mg/m2 to 1.5mg/m2 (normal is 1mg, and that's for people with raging disease, not the complete remission which I currently enjoy). And Velcade has caused a lot of GI pain that requires Vicodin to keep at bay...so I'm not looking forward to increasing it. However, Dex is responsible for a lot of ills so I'll be glad to be rid of it.
So all this would be fine, if a little unnerving...I'm done with maintenance, I'm still in complete remission, I've got some small lesions that haven't resolved yet, and I'm staying on Velcade until they fully resolve.
Except it's not that easy.
UAMS is very advanced in its genetic assessment of the disease. In an era where most centers still rely on something called FISH (fluorescence in situ hybridization), a test that was developed 25+ years ago to look for out-of-place chromosomes, UAMS uses an assessment of 80 genes which, given its massive database of tissue samples, can indicate the risk profile of a given patient with accuracy. The test is called a "gene array" or "gene expression profile" and involves a large core sample of bone marrow. I had four of these done over about a four week period beginning a little before my therapy started in February of 2009 and going a couple of weeks into it. These tests indicated that I had low-risk disease with some high-risk characteristics, and based on those high-risk characteristics I was given the additional Velcade (1.3mg/m2 versus 1.0mg/m2) in maintenance. I have not had a gene array done since then because (a) they are painful, and (b) they did not have further clinical significance other than assigning this low- or high-risk categorization.
Until now. Now they are still painful, but they do have some further clinical significance.
One of the genes they profile is called MYC. This gene was originally linked to a type of Lymphoma. Is essentially acts as a "utility infielder" with respect to genetic screwups that cause cancer. Myeloma cells are abnormal either because chromosomes have been deleted (chromosome 13 is a common deletion that used to be considered a high risk factor, as an example) or added, or because there are chromosomes that have been translocated within a given cell (meaning parts of the cell's genetic code have been swapped). A common if not typical translocation is 4;14 -- meaning the 4th something-or-other is where the 14th-something-or-other should be and vice versa. And the commonality of some types of translocations means that there are certain genetic components that are prone to swapping with other parts.
The MYC gene acts as a utility infielder because it can essentially cause any part of the genetic locus on which it appears to swap with any other part. Having this gene over-expressed is therefore a bad thing. In the not-quite-four years since I started therapy, they have learned enough to know that it is, in fact, a VERY bad thing. When I was originally diagnosed and BB was going through the genes with the chief genetic dude in his group, they were puzzled by something. I had some important low-risk factors, but a puzzling backdrop. They didn't understand its significance at the time. Now they do.
This MYC gene, along with the others, is measured in some kind of units. I don't know the scale, but it looks like, from a review of my data, everything is in the 300 to 1500 unit range.
My MYC genes were between 13,000 and 20,000.
And the significance is this MYC gene can cause a sudden and unexpected loss of remission in low-risk patients that have done well in therapy and are seemingly on their way to being cured.
To wit, me.
And my friend BB (a patient, not the doctor), who unfortunately lost remission about six months ago and has been undergoing absolutely hellish treatment trying to get the disease back under control. He has been told by BB (this time the doctor), who originally told him he was likely to be able to cure him, that "we are not talking about cure any more...we are talking about control." And BB (both of them) know the prognosis is dire. Essentially BB (both of them, but especially the patient) is relying on new agents to be developed so that as current ones fail -- including both Carfilzomib and Pomalidomide in BB's case -- new ones can take their place and keep the Myeloma at bay.
Since my MYC gene is "sky high" to quote BB (back to the doctor now, unless otherwise noted) I am at particular risk for losing remission, and to be frank, losing my battle here.
In short, if the disease comes back, I move from the green line to the blue line. The Y-axis is remission but might as well be a proxy for survival.
You will see that the green line (hell, I think it's green, I'm colorblind and on a graph of this size I can't distinguish it well...it could also be red, but I know it's not the blue one) is almost flat after three years. Let's say that 95% of people don't lose remission, among those 148. But it might be that 10 of those 148 have this MYC gene and 7 of them lose remission.
Unfortunately, that is the sub group in which I may now find myself...
UNLESS the three years of therapy I underwent have caused my genetic profile to change and this MYC is no longer expressed abnormally.
So I underwent several Fine Needle Aspirations of former lesion sites to see what the genetic material in there looks like, and a gene array, and a regular bone marrow. I will be looking for the results of the marrow (to confirm continued remission and hopefully not to reflect any pre-leukemic cells) in the next couple of days. It should have been done last week but the sample was damaged somehow -- this has no clinical significance. They may just have dropped it or it may have been done in a former site where there wasn't enough marrow left to do anything with. So they are going to use one of the FNA aspirations for this analysis instead.
I will be looking for the result of the FNA to additionally confirm that there are no myelomic cells. The pits in my spine are not large enough to take a sample from, but they can go to a former site in my hip (which is where they went) for it, so they took a number of samples there.
This brings up ANOTHER problem. I was told the lesion in my hip (the ilium, for you bone fans) was fully resolved. But evidently BB and RVH (the guy who does the FNA work and reads MRIs) aren't fully satisfied because there is heterogenous marrow there. So I may not even be able to be as confident about the lesions I *THOUGHT* were resolved...let alone about the ones that haven't resolved yet.
Anyhow, if the marrow and FNAs are normal, then I will be waiting only on the gene array analysis which will not be ready until Friday. This will be an important one because it will reveal how extensively the MYC gene is expressed.
If everything is normal, then I breathe easier, stay on Velcade and wait for the lesions in the spine to heal.
If the current marrow is normal but the gene is still expressed, then I have to consider more aggressive therapy -- even though I am still in complete remission. And I will be scared to death.
If the current marrow is abnormal, then it's even worse.
All this makes the selection of the ongoing drugs that much more important. If I'm only on Velcade, will that be enough? After I suggested Pomalidomide, BB said "I'm also thinking possibly Interferon" which was a component of earlier Total Therapy trials but which wasn't demonstrated to have any increase in overall survival -- just progression-free survival. So it was removed from the protocol in favor of VRD maintenance some time ago...I don't know precisely when but it's out there on the interwebs (sic) for anybody who is really interested. This makes me nervous...BB normally has an answer for everything and now he is operating on intuition and gut instead of data and protocol, and that scares the crap outta me.
I then said "do I need to do something more drastic, like another round of VTD-PACE." Long-term readers, as well as other informed Myeloma folks, may recognize this as a cocktail of potent chemotherapy including Cisplatin, Adriamycin, Cytoxin and Etoposide, as well as the comparatively trivial velcade, thalidomide and dex. BB smiled wryly and said "this was going through my mind as well...this is the problem with you, you know too damn much." :) He then suggested that I consider going on anti-depressants as he wanted to be completely honest with me about what he is giving me and why, and that the conversations were likely to lead to a lot of anxiety. I certainly understand the anxiety part...and I have NOTHING WHATSOEVER against anti-depressants or those who take them. However, I'd resisted them in the past because I knew I was going to be putting chemicals into every other organ in the body and taxing the heart (Adriamycin), the ears (Cisplatin), the liver (EVERYTHING), the kidneys (likewise, everything), etc. I wanted to keep the brain as one organ that wasn't targeted for chemical change. I have also "lost a bit off my fastball" in terms of mental acuity, which is VRD-related and should improve as these meds are reduced or wound down...but I don't want to do anything else to the ol' bean if possible.
Nonetheless, I can't deny that facing the renewed prospect of the sleeping dragon here -- after I thought we'd been going about the process of slaying it rather effectively over the past 3.5 years of aggressive therapy -- is a very disconcerting and stressful thing. Depending upon the outcome of these marrow tests, I may or may not need to add Cymbalta to the drug cocktail that I will be on. In the meantime, I shall medicate with mild doses of fermented juniper, grapes and wheat as circumstances merit (usually determined by time of day!)
So my friends, triumph is momentarily replaced by trepidation. Confidence by anxiety. Relief by stress.
What remains constant are the love and support of my family, my friends, the readers of this blog, and the team at UAMS -- for all of which I am grateful.
(Addendum: apropos of my recent Churchill reference, he is reputed to have said "ending a sentence in a preposition is something up with which I shall not put." How does one properly conjugate the preceding paragraph? I could see "for which I am grateful" except I really want to convey the point that I'm grateful for all the components of support! Got any suggestions? This is the type of crap that I think about to keep my mind off my physiology at 5:13AM!)
I've had a couple of days to think through what the current situation is and so I'm going to try to recap it here.
I've finished three years of maintenance therapy. This is supposed to be the "woo-hoo!" moment at UAMS when BB tells me "the Myeloma is gone and will not be coming back" and I can drop all meds except Acyclovir (the anti-viral that keeps Shingles away, which I need to stay on while my immune system recovers, which it would finally be allowed to do since I would be off the meds that suppress it).
Quoting the now 70+ year old BB directly from last week's appointment, "my usual approach is to continue to treat until such time as all the sh*t is outta there, so to speak." This means traditional evidence of complete remission (no M-spike under the most stringent blood tests, normal urine, normal marrow) but also what BB called "Arkansas complete remission" (or MRI complete remission) which also means that all formerly-active lesions in the bones are fully resolved (i.e. replaced / refilled) with new bone, as confirmed under MRI. His hypothesis is that these lesions are microenvironments in which myeloma cells can restart. If the lesions are replaced with bone, it means they won't be able to do so.
We have been watching my 19 formerly active lesions resolve over the last three years of maintenance therapy, and all have gone (so I thought) except for five small ones in my spine, which have shrunk from 2.5cm at baseline (i.e., when I showed up to be treated) to 4 mm as of a 18 months ago. But they have remained stable over these past 18 months. I was hoping to see them gone since in addition to the normal maintenance protocol of Velcade, Revlimid and Dex, I was on the bone-strengthening bisphosphonate agent Zometa, the frequency of which was increased to one infusion per month over the last six months (I think I got four of them, actually -- same difference since this aspect of treatment is far from an exact science).
Last week, the MRI revealed that the five spinal lesions had still not resolved. They were termed "small" and were not sized, but in the summary of results they were considered "stable" relative to the last scan six months ago. This was problem number one. BB wants to continue to treat until such time as...uh...well until such time as these are fully resolved, to use more polite phraseology than was employed in the actual consult. In and of itself, this wouldn't be a huge deal...but this prompts questions about what medicine(s) to continue to take while waiting for resolution, and how effective they will be.
I've been on Velcade, Revlimid and Dexamethasone for three years of maintenance, but readers will know that I've had concerns about continuing on Revlimid. It has been a key agent in maintenance therapy since Total Therapy 3 was begun in around 2003 and is widely used now. About a year ago, it was noticed (by numerous entities, including the company that produces it) that Revlimid was associated with secondary malignancies -- solid cell tumors and leukemia, to be precise. I had a squamous cell carcinoma in my finger, so we can check that box. I had pre-leukemic cells in my marrow six months ago...so before we check that box, BB wants me off this stuff. I agree. For a while, the value of Revlimid (inclusive of these risks) is a no-brainer. But after three years, has it done everything that it should do? Is it now at the point where the risk of continued use is greater than the risk of remission loss? Perhaps. In fact, normally I would be pretty easy to convince except for certain aspects of my current situation.
Then there is the matter of -- for someone looking to continue maintenance with some urgency -- what it can be replaced by. I want to keep up the attack on whatever rogue cells aren't yet with the program and make my body as inhospitable as possible for Myeloma cells while my bones continue to heal. I suggested Pomalidomide, which as many readers know, is the next generation Revlimid. BB said "yeah, good idea, but we can't get it." I believe this is because Pomalidomide is still only available -- even to Arkansas -- as a single agent except perhaps in refractory cases, and I'm thankfully not yet a refractory case. And if we are to use just one agent, BB wants to keep me on Velcade since he believes this is the most effective anti-Myeloma agent there is. He asked me if I can tolerate it without the Dex and I said "sure!" -- mostly because I want off the Dex. So that does seem to indicate that Dex in maintenance is not used for its plasmacytolitic (i.e. killing plasma cells) properties but because it helps counterract the effects of Velcade (flu-like symptoms, GI issues, etc.) I will be increasing the dosage of Velcade from the already high 1.3mg/m2 to 1.5mg/m2 (normal is 1mg, and that's for people with raging disease, not the complete remission which I currently enjoy). And Velcade has caused a lot of GI pain that requires Vicodin to keep at bay...so I'm not looking forward to increasing it. However, Dex is responsible for a lot of ills so I'll be glad to be rid of it.
So all this would be fine, if a little unnerving...I'm done with maintenance, I'm still in complete remission, I've got some small lesions that haven't resolved yet, and I'm staying on Velcade until they fully resolve.
Except it's not that easy.
UAMS is very advanced in its genetic assessment of the disease. In an era where most centers still rely on something called FISH (fluorescence in situ hybridization), a test that was developed 25+ years ago to look for out-of-place chromosomes, UAMS uses an assessment of 80 genes which, given its massive database of tissue samples, can indicate the risk profile of a given patient with accuracy. The test is called a "gene array" or "gene expression profile" and involves a large core sample of bone marrow. I had four of these done over about a four week period beginning a little before my therapy started in February of 2009 and going a couple of weeks into it. These tests indicated that I had low-risk disease with some high-risk characteristics, and based on those high-risk characteristics I was given the additional Velcade (1.3mg/m2 versus 1.0mg/m2) in maintenance. I have not had a gene array done since then because (a) they are painful, and (b) they did not have further clinical significance other than assigning this low- or high-risk categorization.
Until now. Now they are still painful, but they do have some further clinical significance.
One of the genes they profile is called MYC. This gene was originally linked to a type of Lymphoma. Is essentially acts as a "utility infielder" with respect to genetic screwups that cause cancer. Myeloma cells are abnormal either because chromosomes have been deleted (chromosome 13 is a common deletion that used to be considered a high risk factor, as an example) or added, or because there are chromosomes that have been translocated within a given cell (meaning parts of the cell's genetic code have been swapped). A common if not typical translocation is 4;14 -- meaning the 4th something-or-other is where the 14th-something-or-other should be and vice versa. And the commonality of some types of translocations means that there are certain genetic components that are prone to swapping with other parts.
The MYC gene acts as a utility infielder because it can essentially cause any part of the genetic locus on which it appears to swap with any other part. Having this gene over-expressed is therefore a bad thing. In the not-quite-four years since I started therapy, they have learned enough to know that it is, in fact, a VERY bad thing. When I was originally diagnosed and BB was going through the genes with the chief genetic dude in his group, they were puzzled by something. I had some important low-risk factors, but a puzzling backdrop. They didn't understand its significance at the time. Now they do.
This MYC gene, along with the others, is measured in some kind of units. I don't know the scale, but it looks like, from a review of my data, everything is in the 300 to 1500 unit range.
My MYC genes were between 13,000 and 20,000.
And the significance is this MYC gene can cause a sudden and unexpected loss of remission in low-risk patients that have done well in therapy and are seemingly on their way to being cured.
To wit, me.
And my friend BB (a patient, not the doctor), who unfortunately lost remission about six months ago and has been undergoing absolutely hellish treatment trying to get the disease back under control. He has been told by BB (this time the doctor), who originally told him he was likely to be able to cure him, that "we are not talking about cure any more...we are talking about control." And BB (both of them) know the prognosis is dire. Essentially BB (both of them, but especially the patient) is relying on new agents to be developed so that as current ones fail -- including both Carfilzomib and Pomalidomide in BB's case -- new ones can take their place and keep the Myeloma at bay.
Since my MYC gene is "sky high" to quote BB (back to the doctor now, unless otherwise noted) I am at particular risk for losing remission, and to be frank, losing my battle here.
In short, if the disease comes back, I move from the green line to the blue line. The Y-axis is remission but might as well be a proxy for survival.
You will see that the green line (hell, I think it's green, I'm colorblind and on a graph of this size I can't distinguish it well...it could also be red, but I know it's not the blue one) is almost flat after three years. Let's say that 95% of people don't lose remission, among those 148. But it might be that 10 of those 148 have this MYC gene and 7 of them lose remission.
Unfortunately, that is the sub group in which I may now find myself...
UNLESS the three years of therapy I underwent have caused my genetic profile to change and this MYC is no longer expressed abnormally.
So I underwent several Fine Needle Aspirations of former lesion sites to see what the genetic material in there looks like, and a gene array, and a regular bone marrow. I will be looking for the results of the marrow (to confirm continued remission and hopefully not to reflect any pre-leukemic cells) in the next couple of days. It should have been done last week but the sample was damaged somehow -- this has no clinical significance. They may just have dropped it or it may have been done in a former site where there wasn't enough marrow left to do anything with. So they are going to use one of the FNA aspirations for this analysis instead.
I will be looking for the result of the FNA to additionally confirm that there are no myelomic cells. The pits in my spine are not large enough to take a sample from, but they can go to a former site in my hip (which is where they went) for it, so they took a number of samples there.
This brings up ANOTHER problem. I was told the lesion in my hip (the ilium, for you bone fans) was fully resolved. But evidently BB and RVH (the guy who does the FNA work and reads MRIs) aren't fully satisfied because there is heterogenous marrow there. So I may not even be able to be as confident about the lesions I *THOUGHT* were resolved...let alone about the ones that haven't resolved yet.
Anyhow, if the marrow and FNAs are normal, then I will be waiting only on the gene array analysis which will not be ready until Friday. This will be an important one because it will reveal how extensively the MYC gene is expressed.
If everything is normal, then I breathe easier, stay on Velcade and wait for the lesions in the spine to heal.
If the current marrow is normal but the gene is still expressed, then I have to consider more aggressive therapy -- even though I am still in complete remission. And I will be scared to death.
If the current marrow is abnormal, then it's even worse.
All this makes the selection of the ongoing drugs that much more important. If I'm only on Velcade, will that be enough? After I suggested Pomalidomide, BB said "I'm also thinking possibly Interferon" which was a component of earlier Total Therapy trials but which wasn't demonstrated to have any increase in overall survival -- just progression-free survival. So it was removed from the protocol in favor of VRD maintenance some time ago...I don't know precisely when but it's out there on the interwebs (sic) for anybody who is really interested. This makes me nervous...BB normally has an answer for everything and now he is operating on intuition and gut instead of data and protocol, and that scares the crap outta me.
I then said "do I need to do something more drastic, like another round of VTD-PACE." Long-term readers, as well as other informed Myeloma folks, may recognize this as a cocktail of potent chemotherapy including Cisplatin, Adriamycin, Cytoxin and Etoposide, as well as the comparatively trivial velcade, thalidomide and dex. BB smiled wryly and said "this was going through my mind as well...this is the problem with you, you know too damn much." :) He then suggested that I consider going on anti-depressants as he wanted to be completely honest with me about what he is giving me and why, and that the conversations were likely to lead to a lot of anxiety. I certainly understand the anxiety part...and I have NOTHING WHATSOEVER against anti-depressants or those who take them. However, I'd resisted them in the past because I knew I was going to be putting chemicals into every other organ in the body and taxing the heart (Adriamycin), the ears (Cisplatin), the liver (EVERYTHING), the kidneys (likewise, everything), etc. I wanted to keep the brain as one organ that wasn't targeted for chemical change. I have also "lost a bit off my fastball" in terms of mental acuity, which is VRD-related and should improve as these meds are reduced or wound down...but I don't want to do anything else to the ol' bean if possible.
Nonetheless, I can't deny that facing the renewed prospect of the sleeping dragon here -- after I thought we'd been going about the process of slaying it rather effectively over the past 3.5 years of aggressive therapy -- is a very disconcerting and stressful thing. Depending upon the outcome of these marrow tests, I may or may not need to add Cymbalta to the drug cocktail that I will be on. In the meantime, I shall medicate with mild doses of fermented juniper, grapes and wheat as circumstances merit (usually determined by time of day!)
So my friends, triumph is momentarily replaced by trepidation. Confidence by anxiety. Relief by stress.
What remains constant are the love and support of my family, my friends, the readers of this blog, and the team at UAMS -- for all of which I am grateful.
(Addendum: apropos of my recent Churchill reference, he is reputed to have said "ending a sentence in a preposition is something up with which I shall not put." How does one properly conjugate the preceding paragraph? I could see "for which I am grateful" except I really want to convey the point that I'm grateful for all the components of support! Got any suggestions? This is the type of crap that I think about to keep my mind off my physiology at 5:13AM!)
The second opinion derby, redux
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Howdy folks.
After getting knocked about a bit, I think I have found my sea-legs a bit and am going about the process of speaking to people that have specifically studied this MYC gene and may have thoughts on how to target it with specific maintenance drugs. Of course my hope and expectation is to still handle all of this through UAMS but it can't hurt to be informed and I feel like BB is operating from the gut versus from a pool of data so it also can't hurt for me to understand how other's guts would lead them.
It may be challenging to do so. Consider the fact, for example, that I remain in complete remission. I can't send anybody slides of bone marrow because it won't show any myeloma cells. I can't send anybody blood because it will be normal. Nobody else really uses MRIs the way UAMS does; if I sent them an MRI it would show a few small inactive lesions and some heterogenous marrow which is to be expected from myeloablative therapy.
I think there are probably a limited number of doctors who would even consider ANY kind of maintenance for somebody in my condition, having concluded three years of VRD and retained remission that whole time.
Nonetheless, I've begun looking at which doctors have looked at the MYC gene -- either with respect to Myeloma or even with respect to other blood cancers. The people whom I'm hoping to speak with include:
- KA at Dana Farber. He's done work on MYC and he's a leader with novel agents. Ironically, friend and fellow blogger GP was incredibly kind and sent a brief summary of my situation to KA's partner, PR. He responded immediately by saying I should be speaking to somebody else outside Dana Farber. : \ Oh well, I'm still intending to do my phone consult with KA next Tuesday. But this leads us to...
- RF at Mayo Scottsdale. He evidently has done extensive research on MYC and is considered the leading expert on this gene (or at least one of them). He's done presentations with BB on treatment of high risk MM before so they at least know each other. I've sent an email to him asking to set up a consult, but haven't heard anything as yet.
- BD at Cedars Sinai. A luminary researcher, he's done work on MYC and probably understands this disease as well as just about anybody. I have a call into him to schedule a phone consult, although I could also drop by since he's local.
- SF at City of Hope. He's got a tremendous amount of experience across different types of blood cancers and has done work on MYC. He also understands BB's protcol. And he's a great person. And close to home. So that checks a lot of boxes.
We'll see if I can speak with at least two of these people -- I'm particularly keen on speaking with RF. Then we'll have some idea of what to throw into the mix along with Velcade if the gene array indicates that I still have this MYC gene running amok.
If I don't, then this is all much ado about no-- well, much ado about very little. I'll still need to stay on Velcade until the lesions resolve even if I don't have the gene problems. But that will be a bump in the road versus a majorly disconcert event.
Fingers crossed for good results on Friday. BJ sent me a little text, since we had trouble getting cells from one of the bone marrow sites, that the results are "going to be good...or it wouldn't be this hard" (to collect the cels, I hope). I presume that at least means that if I had myeloma cells the marrow would be more substantive. This is part of what we hope for, but really we want:
* No myeloma cells
* No myelodysplasia
* No over-expression of MYC
If we're good on all those fronts, then we return to our maintenance program with Velcade alone, most likely, and watch and wait for those little spine pits to resolve.
I shall keep you posted.
I must also say I am particularly touched, as always, by the emails, calls, texts and posts offering support, prayers, positive thoughts and intentions, and even humorous and insightful historical commentary on the evolution of certain conventions in grammar! :)
After getting knocked about a bit, I think I have found my sea-legs a bit and am going about the process of speaking to people that have specifically studied this MYC gene and may have thoughts on how to target it with specific maintenance drugs. Of course my hope and expectation is to still handle all of this through UAMS but it can't hurt to be informed and I feel like BB is operating from the gut versus from a pool of data so it also can't hurt for me to understand how other's guts would lead them.
It may be challenging to do so. Consider the fact, for example, that I remain in complete remission. I can't send anybody slides of bone marrow because it won't show any myeloma cells. I can't send anybody blood because it will be normal. Nobody else really uses MRIs the way UAMS does; if I sent them an MRI it would show a few small inactive lesions and some heterogenous marrow which is to be expected from myeloablative therapy.
I think there are probably a limited number of doctors who would even consider ANY kind of maintenance for somebody in my condition, having concluded three years of VRD and retained remission that whole time.
Nonetheless, I've begun looking at which doctors have looked at the MYC gene -- either with respect to Myeloma or even with respect to other blood cancers. The people whom I'm hoping to speak with include:
- KA at Dana Farber. He's done work on MYC and he's a leader with novel agents. Ironically, friend and fellow blogger GP was incredibly kind and sent a brief summary of my situation to KA's partner, PR. He responded immediately by saying I should be speaking to somebody else outside Dana Farber. : \ Oh well, I'm still intending to do my phone consult with KA next Tuesday. But this leads us to...
- RF at Mayo Scottsdale. He evidently has done extensive research on MYC and is considered the leading expert on this gene (or at least one of them). He's done presentations with BB on treatment of high risk MM before so they at least know each other. I've sent an email to him asking to set up a consult, but haven't heard anything as yet.
- BD at Cedars Sinai. A luminary researcher, he's done work on MYC and probably understands this disease as well as just about anybody. I have a call into him to schedule a phone consult, although I could also drop by since he's local.
- SF at City of Hope. He's got a tremendous amount of experience across different types of blood cancers and has done work on MYC. He also understands BB's protcol. And he's a great person. And close to home. So that checks a lot of boxes.
We'll see if I can speak with at least two of these people -- I'm particularly keen on speaking with RF. Then we'll have some idea of what to throw into the mix along with Velcade if the gene array indicates that I still have this MYC gene running amok.
If I don't, then this is all much ado about no-- well, much ado about very little. I'll still need to stay on Velcade until the lesions resolve even if I don't have the gene problems. But that will be a bump in the road versus a majorly disconcert event.
Fingers crossed for good results on Friday. BJ sent me a little text, since we had trouble getting cells from one of the bone marrow sites, that the results are "going to be good...or it wouldn't be this hard" (to collect the cels, I hope). I presume that at least means that if I had myeloma cells the marrow would be more substantive. This is part of what we hope for, but really we want:
* No myeloma cells
* No myelodysplasia
* No over-expression of MYC
If we're good on all those fronts, then we return to our maintenance program with Velcade alone, most likely, and watch and wait for those little spine pits to resolve.
I shall keep you posted.
I must also say I am particularly touched, as always, by the emails, calls, texts and posts offering support, prayers, positive thoughts and intentions, and even humorous and insightful historical commentary on the evolution of certain conventions in grammar! :)
PHEW!!!!!! Good news from Arkansas!
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First of all, thank you all SO much for your prayers, emails, voicemails, texts, comments, intentions, positive vibes and well wishes. They do make a difference, both in how challenging news is handled and, perhaps, in the outcome of events. I deeply appreciate them!
So, let me share the good news. My gene array came back about as good as it possibly could have, which means:
1. Negative for myeloma (and this was in the heterogenous marrow of a former lesion, so if it was gonna show up anyplace, that is where it would show up)
2. "No cytogenetic evidence of myelodysplasia" which means, most likely, that there were some funky looking white cells but they are made to look funky by the Revlimid, rather than my body manufacturing them. We're off Revlimid so hopefully that will all resolve by next time but meanwhile, my marrow doesn't appear to be pre-leukemic. Phew!!!
3. The MYC gene which was over-expressed (the numbers being 18,390 and 13,928 in the two gene arrays I did before I started treatment, 17,000 after one day of Velcade and 19,602 after one week of treatment) came back at 3,200. This puts it clearly in the second quartile (meaning somewhere between 50 and 75% of patients have more of this gene than me). I need to speak with Bart to find out what this means, exactly, but it's no longer over-expressed. So that MAY mean that I don't need to worry about spontaneous remission loss.
Triple phew!
One lingering question I have is whether or not my friend BB (the patient, not the doctor) who unfortunately lost remission due to this MYC gene had experienced a similar "normalization" through therapy -- in which case I'm not out of the woods -- or if his MYC gene had never been "normalized." If the latter is the case, than it likely means that I won't face a high chance of remission loss -- and it means that BB (the patient) can look to his own MYC marker going forward in treatment as something that could indicate the efficacy of his therapy. If the former is the case, then I still need to worry -- because he lost remission and if his MYC gene was normalized, then even though mine is not being over-expressed, I'm still at risk.
At least until those lesions resolve and the bone marrow becomes homogenous. I had thought we only needed to look for the first but based on BB's (the doctor, now) concerns last week I might need to wait for the heterogenous marrow to give way to homogenous marrow. Although I'd also been told in the past that this may never happen given the destruction of the marrow during transplants. So I'm not sure.
Another conversation with BB (the doctor) is in order and I'm setting that up.
We still need to figure out what maintenance drugs to use since I'm now off Revlimid -- we want those stupid pits in my spine to heal up so we can breathe easier and get back to the "you're cured" track! How I long for those words...
For the moment, though, the concerns of last week have abated. Good lord, it's hard to explain how much stress that puts somebody through -- I'm not sure I fully realized it myself until the burden of that anxiety was lifted with this news. I'm really emotionally spent.
Time to celebrate this evening with a great bottle of champagne!!!
Thank you all -- I will continue to update frequently as I learn more, including in numerous consults over the next couple of weeks.
So, let me share the good news. My gene array came back about as good as it possibly could have, which means:
1. Negative for myeloma (and this was in the heterogenous marrow of a former lesion, so if it was gonna show up anyplace, that is where it would show up)
2. "No cytogenetic evidence of myelodysplasia" which means, most likely, that there were some funky looking white cells but they are made to look funky by the Revlimid, rather than my body manufacturing them. We're off Revlimid so hopefully that will all resolve by next time but meanwhile, my marrow doesn't appear to be pre-leukemic. Phew!!!
3. The MYC gene which was over-expressed (the numbers being 18,390 and 13,928 in the two gene arrays I did before I started treatment, 17,000 after one day of Velcade and 19,602 after one week of treatment) came back at 3,200. This puts it clearly in the second quartile (meaning somewhere between 50 and 75% of patients have more of this gene than me). I need to speak with Bart to find out what this means, exactly, but it's no longer over-expressed. So that MAY mean that I don't need to worry about spontaneous remission loss.
Triple phew!
One lingering question I have is whether or not my friend BB (the patient, not the doctor) who unfortunately lost remission due to this MYC gene had experienced a similar "normalization" through therapy -- in which case I'm not out of the woods -- or if his MYC gene had never been "normalized." If the latter is the case, than it likely means that I won't face a high chance of remission loss -- and it means that BB (the patient) can look to his own MYC marker going forward in treatment as something that could indicate the efficacy of his therapy. If the former is the case, then I still need to worry -- because he lost remission and if his MYC gene was normalized, then even though mine is not being over-expressed, I'm still at risk.
At least until those lesions resolve and the bone marrow becomes homogenous. I had thought we only needed to look for the first but based on BB's (the doctor, now) concerns last week I might need to wait for the heterogenous marrow to give way to homogenous marrow. Although I'd also been told in the past that this may never happen given the destruction of the marrow during transplants. So I'm not sure.
Another conversation with BB (the doctor) is in order and I'm setting that up.
We still need to figure out what maintenance drugs to use since I'm now off Revlimid -- we want those stupid pits in my spine to heal up so we can breathe easier and get back to the "you're cured" track! How I long for those words...
For the moment, though, the concerns of last week have abated. Good lord, it's hard to explain how much stress that puts somebody through -- I'm not sure I fully realized it myself until the burden of that anxiety was lifted with this news. I'm really emotionally spent.
Time to celebrate this evening with a great bottle of champagne!!!
Thank you all -- I will continue to update frequently as I learn more, including in numerous consults over the next couple of weeks.
BB's phone message, KA's advice and sub-Q velcade
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Some quick and sundry updates here.
First, although I had pried the information from his team last Friday, BB himself called me on Monday (I don't know why but I didn't see the phone "ringing" or vibrating). I was hoping to actually embed the audio here but I can't do it at this time (will do my best since the cadence is what makes this humorous). Anyhow, the voicemail is:
So the plan at present is to continue on single agent Velcade in a ~20% higher dose (1.5mg/m2) until those damn pits in my spine heal up, with a check-up (including bone marrow, PET, MRI, etc.) in six months' time and cancer markers run every two weeks from blood.
I spoke with KA yesterday on a phone consult to validate this approach. It was a very pleasant conversation, the highlights of which were:
First, although I had pried the information from his team last Friday, BB himself called me on Monday (I don't know why but I didn't see the phone "ringing" or vibrating). I was hoping to actually embed the audio here but I can't do it at this time (will do my best since the cadence is what makes this humorous). Anyhow, the voicemail is:
"Hey Nick, this is Bart. All studies are good and negative. Okay? Great news. Calm down. Thanks, bye."I feel like saying, in full Walter Sobchek mode, "I'm perfectly calm, dude...calmer than you are." And I am, in fact, pretty calm these days.
So the plan at present is to continue on single agent Velcade in a ~20% higher dose (1.5mg/m2) until those damn pits in my spine heal up, with a check-up (including bone marrow, PET, MRI, etc.) in six months' time and cancer markers run every two weeks from blood.
I spoke with KA yesterday on a phone consult to validate this approach. It was a very pleasant conversation, the highlights of which were:
- He agrees that I should remain on something to ensure the full adherence to BB's approach with its hope for cure
- He agrees that Revlimid should be discontinued since I've had a ton of alkalyting agents (e.g., platinum, adriamycin, cytoxan, etoposide, melphalan in high dose) that alter DNA and it is in combination with these alkalyting agents that Revlimid use is most likely to lead to myelodysplasia and, potentially, Leukemia
- He thinks Interferon wouldn't do anything other than make me feel like I have the flu constantly
- He thinks a proteasome inhibitor (like Velcade) could be a long-term option for me (as in potentially forever) and that in a couple of years there is likely to be an oral version (i.e., a pill) that would make it easier to take. I think he doesn't full subscribe to Bart's confidence in a cure provided the MRI is clean. We'll see -- this stuff remains poison and I don't want to be on it forever.
- He "wouldn't sell the house simply because of the MYC gene." While it is no longer over-expressed, I still wanted KA's thoughts on it. He said that "with respect, [BB] is probably guessing about its responsibility for the remission loss" and I'm sure BB might agree, but I don't know how extensive the regression studies are so it might be a very educated guess -- or it could be statistically proven. At any rate, the fact that it is normally expressed gives me some comfort -- particularly when combined with BB's voicemail. I asked KA what maintenance drugs target MYC and he said "a few years ago, I'd have said none...but it turns out they all do. Revlimid is particularly effective." So perhaps Revlimid is what caused the MYC to normalize over the last three years of therapy.
- He noted that over time, the bones should resolve and the heterogenous marrow should probably even become homogenous but that he wouldn't use the latter as a requirement of remission (he wouldn't say cure, obviously). He said that PET scans were extremely sensitive and the marrow funkiness could be caused by many things (e.g., an inflammation). I didn't bother to mince words and point out that we were talking MRI since clearly Arkansas and Dana Farber diverge on treatment long before this point.
Friday, September 28, 2012
Ayurvedic Treatment of Eosinophilea, Causes, Herbs and Natural supplements
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Ayurvedic treatment of eosinophilea - causes, Herbs and Natural supplements
What is Eosinophilea Eosinophilia is a condition in which the count of eosinophils in the blood increases more than 0.45×109/L (450/μl). It is diagnosed by doing the complete blood count. Eosinophils or the Eosinophil granulocytes, are white blood cells that are one of the immune system cells which help us to fight certain infections or allergies and in the process of fighting with the invaders, lead to inflammatory process in the body. Their no. increases as a response to invasion or allergens. Steroids are not the answer to the increased immune response i.e. Eosinophilea. There are many natural supplements and herbs available in nature which can help in combating all major causes of Eosinophilea. One of the most effective herbal combination for eosinophilea is Aller-G Care capsules, Praanrakshak Churna, Tulsi capsules and Curcumin Capsules.
CAUSES OF EOSINOPHILEA There are several underlying diseases which cancause elevated eosinophil counts. The eosinophils are increased in thefollowing conditions –
1. All Allergic disorders
If we look closely at the above mentioned causesof Eosinophilea, then we can observe that the allergy and immune reaction tosome underlying pathogen is the major cause of eosinophilea. Eosinophils areactully immunity cells which increases as a response to some underlying stimulus or reaction to somepathological condition in the body.
Treatment of Eosinophilea - The modernmedical treatment of eosinophilea consists of treatment of underlying disorderand usually the steroids are given to keepthe inflammatory process in control, but there are so many side effects ofsteroids use in Eosinophilea. So it is better to use some natural supplementsor herbs to treat the immune response in a natural way. Ayurvedic treatment ofeosinophilea consists of using special herbal combinations which are veryhelpful in getting rid of the problem naturally without causing any sideeffects.
AYURVEDIC TREATMENT OFEOSINOPHILEA
Ayurveda lays emphasis on modification of theimmune response rather than suppression of immunity. The suppression treatmentby steroids can prove fatal in some cases of Eosinophilea especially when it isbecause of parasitic invasion. So it is better to use ayurvedicimmuno-modulating herbs to fight this disease.
One of the best natural supplement havinganti-inflammatory, analgesic, anti-allergic properties is Turmeric. We useCurcumin Capsules - 500 mg ( Explained in detail at - www.planetcurcumin.com or www.planetayurveda.com/haldipowder.htm ) are suitable to be used in increasedeosinophils due to asthma, allergies and other inflammatory reactions.
Another best natural supplement for eosinophileais Tulsi. Tulsi or ocimum sanctum is best known for its anti-viral,anti-bacterial, anti-septic, anti-asthmatic, immuno-modulating, anti-allergicproperties. So this is used in the combination of herbs found in the formulacalled - Aller-G care capsules.
The Aller-G Care Package mentioned at Aller-G Care Page Here is an excellent way to treat eosinophilea naturally without cause any side effects.
What is Eosinophilea Eosinophilia is a condition in which the count of eosinophils in the blood increases more than 0.45×109/L (450/μl). It is diagnosed by doing the complete blood count. Eosinophils or the Eosinophil granulocytes, are white blood cells that are one of the immune system cells which help us to fight certain infections or allergies and in the process of fighting with the invaders, lead to inflammatory process in the body. Their no. increases as a response to invasion or allergens. Steroids are not the answer to the increased immune response i.e. Eosinophilea. There are many natural supplements and herbs available in nature which can help in combating all major causes of Eosinophilea. One of the most effective herbal combination for eosinophilea is Aller-G Care capsules, Praanrakshak Churna, Tulsi capsules and Curcumin Capsules.
CAUSES OF EOSINOPHILEA There are several underlying diseases which cancause elevated eosinophil counts. The eosinophils are increased in thefollowing conditions –
1. All Allergic disorders
If we look closely at the above mentioned causesof Eosinophilea, then we can observe that the allergy and immune reaction tosome underlying pathogen is the major cause of eosinophilea. Eosinophils areactully immunity cells which increases as a response to some underlying stimulus or reaction to somepathological condition in the body.
Treatment of Eosinophilea - The modernmedical treatment of eosinophilea consists of treatment of underlying disorderand usually the steroids are given to keepthe inflammatory process in control, but there are so many side effects ofsteroids use in Eosinophilea. So it is better to use some natural supplementsor herbs to treat the immune response in a natural way. Ayurvedic treatment ofeosinophilea consists of using special herbal combinations which are veryhelpful in getting rid of the problem naturally without causing any sideeffects.
AYURVEDIC TREATMENT OFEOSINOPHILEA
Ayurveda lays emphasis on modification of theimmune response rather than suppression of immunity. The suppression treatmentby steroids can prove fatal in some cases of Eosinophilea especially when it isbecause of parasitic invasion. So it is better to use ayurvedicimmuno-modulating herbs to fight this disease.
One of the best natural supplement havinganti-inflammatory, analgesic, anti-allergic properties is Turmeric. We useCurcumin Capsules - 500 mg ( Explained in detail at - www.planetcurcumin.com or www.planetayurveda.com/haldipowder.htm ) are suitable to be used in increasedeosinophils due to asthma, allergies and other inflammatory reactions.
Another best natural supplement for eosinophileais Tulsi. Tulsi or ocimum sanctum is best known for its anti-viral,anti-bacterial, anti-septic, anti-asthmatic, immuno-modulating, anti-allergicproperties. So this is used in the combination of herbs found in the formulacalled - Aller-G care capsules.
The Aller-G Care Package mentioned at Aller-G Care Page Here is an excellent way to treat eosinophilea naturally without cause any side effects.
 |
| AYURVEDIC TREATMENT OF EOSINOPHILEA - THE PRODUCTS CAN BE PURCHASED ONLINE AS WELL AS IF YOU ARE IN INDIA, YOU CAN CONTACT MR. ASHWANI THAKUR AT +91-9915593604 FOR DELIVERY WITHIN INDIA |
LIVER CIRRHOSIS DIET - Food in Liver Failure
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Diet in Liver Cirrhosis and Liver Failure
Liver is the seat of metabolism in the body. Whatever food we eat, after digestion passes through liver and after proper inspection, the liver processes the food into various parts. The proteins are processed and broken down into amino acids. The carbohydrates into glucose molecules, the fats into amino acids. The vitamins and minerals are utilized in various enzymatic chemical reactions to break down and convert the food into utilizable form. Liver cells use various enzymes to perform these functions. The hepatocytes or liver cells work hard to keep us disease free as they also halt the entry of bacteria and viruses into our body. The chemical drugs, preservatives, alcohol, pollutants are also toxic to the liver as liver cells work at war scale to commit suicide to neutralize the toxins overload.
DIET IN LIVER CIRRHOSIS AND FAILURE
The diet in liver failure - The liver cirrhosis diet should be a very balanced diet.
What food to be avoided in liver failure
Alcohol, High protein diet, Cheese, Peanuts, Dry fruits, wine, beer, All packaged food which contain preservatives, frozen food, soft drinks, Non-veg diet, sea food and eggs ( Egg white can be given if the albumin is very low). Spices like ginger, turmeric, garlic are not recommended as they are pungent in nature. Alcohol is also pungent in nature. So pungents are not recommended in liver failure.
Which diet is good in liver cirrhosis
Coconut water is excellent in liver cirrhosis. Drink fresh coconut water, daily in the morning. All fruits, vegetables which are bitter in taste are excellent. By Bitter, I mean Bitter and not pungent. There are 6 tastes in total. Sweet, Sour, Salty, Pungent, Bitter and Astringent.
Bitter tasting vegetables are - all gourds, long gourd, bottle gourd, round gourds, bitter gourds.
Other foods good in liver failure are Turnips, radish, carrots, potatoes. Radish juice- 10-20 ml once daily is recommended.
Liver CirrhosisDiet
It is very important to cleanse the liver. Drinking water is very important if there is no water retention or ascites. Drinking a lotof water helps the liver to clean the toxins more effectively. Minimizing thealcohol and drug intake also helps in improved liver function and therebylongevity.
Consuming raw vegetablesin the diet plan, especially dark and leafy vegetables, cabbage, wasabi,broccoli, onion, turnip, bok choy etc. different types of berries. avoid sour fruits at all cost. Lemons, oranges are not recommended at all.
Try to includeseeds in the diet such as sunflower, flax, pumpkin seeds, andsesame. Small quantity is recommended and twice weekly is fine.
Avoid junk food and Soft drinks - Even if there is no Cirrhosis or you are living normal life -
This machine(Human body) is made by nature and the nature has given the best fuel on ourplanet for running and maintaining this machine. Putting in junk food, drugs,chemicals, preservatives, alcohol, Soda, Soft drinks (all soft drinks containCo2) is just like running your car on kerosene.
When we canfollow the manufacturer’s manual in case of our car and put the right kind ofpremium fuel in it for its proper maintenance why can’t we put the right kindof fuel (natural food) in this nature made machine for its optimumperformance.
Why can’t wefollow nature’s manual i.e. Ayurveda
Why do we haveto drink Co2 (Soft drinks) by spending hard earned money when the body isputting its best efforts to eliminate Co2 from the blood through lungs andmaintain the pH to slightly alkaline.
Have weforgotten that Co2 is an acidic gas ?
Ayurvedic Treatment of Liver Cirrhosis and Hepatitis - Read more about this
Dr. Vikram Chauhan- MD (Ayurveda ) explaining about Liver cirrhosis treatment in Ayurveda. The cirrhosis can be caused by any reason - Hepatitis, Alcohol, Drugs or any other toxins.
Liver is the seat of metabolism in the body. Whatever food we eat, after digestion passes through liver and after proper inspection, the liver processes the food into various parts. The proteins are processed and broken down into amino acids. The carbohydrates into glucose molecules, the fats into amino acids. The vitamins and minerals are utilized in various enzymatic chemical reactions to break down and convert the food into utilizable form. Liver cells use various enzymes to perform these functions. The hepatocytes or liver cells work hard to keep us disease free as they also halt the entry of bacteria and viruses into our body. The chemical drugs, preservatives, alcohol, pollutants are also toxic to the liver as liver cells work at war scale to commit suicide to neutralize the toxins overload.
DIET IN LIVER CIRRHOSIS AND FAILURE
The diet in liver failure - The liver cirrhosis diet should be a very balanced diet.
What food to be avoided in liver failure
Alcohol, High protein diet, Cheese, Peanuts, Dry fruits, wine, beer, All packaged food which contain preservatives, frozen food, soft drinks, Non-veg diet, sea food and eggs ( Egg white can be given if the albumin is very low). Spices like ginger, turmeric, garlic are not recommended as they are pungent in nature. Alcohol is also pungent in nature. So pungents are not recommended in liver failure.
Which diet is good in liver cirrhosis
Coconut water is excellent in liver cirrhosis. Drink fresh coconut water, daily in the morning. All fruits, vegetables which are bitter in taste are excellent. By Bitter, I mean Bitter and not pungent. There are 6 tastes in total. Sweet, Sour, Salty, Pungent, Bitter and Astringent.
Bitter tasting vegetables are - all gourds, long gourd, bottle gourd, round gourds, bitter gourds.
Other foods good in liver failure are Turnips, radish, carrots, potatoes. Radish juice- 10-20 ml once daily is recommended.
Liver CirrhosisDiet
It is very important to cleanse the liver. Drinking water is very important if there is no water retention or ascites. Drinking a lotof water helps the liver to clean the toxins more effectively. Minimizing thealcohol and drug intake also helps in improved liver function and therebylongevity.
Consuming raw vegetablesin the diet plan, especially dark and leafy vegetables, cabbage, wasabi,broccoli, onion, turnip, bok choy etc. different types of berries. avoid sour fruits at all cost. Lemons, oranges are not recommended at all.
Try to includeseeds in the diet such as sunflower, flax, pumpkin seeds, andsesame. Small quantity is recommended and twice weekly is fine.
Avoid junk food and Soft drinks - Even if there is no Cirrhosis or you are living normal life -
This machine(Human body) is made by nature and the nature has given the best fuel on ourplanet for running and maintaining this machine. Putting in junk food, drugs,chemicals, preservatives, alcohol, Soda, Soft drinks (all soft drinks containCo2) is just like running your car on kerosene.
When we canfollow the manufacturer’s manual in case of our car and put the right kind ofpremium fuel in it for its proper maintenance why can’t we put the right kindof fuel (natural food) in this nature made machine for its optimumperformance.
Why can’t wefollow nature’s manual i.e. Ayurveda
Why do we haveto drink Co2 (Soft drinks) by spending hard earned money when the body isputting its best efforts to eliminate Co2 from the blood through lungs andmaintain the pH to slightly alkaline.
Have weforgotten that Co2 is an acidic gas ?
Ayurvedic Treatment of Liver Cirrhosis and Hepatitis - Read more about this
Dr. Vikram Chauhan- MD (Ayurveda ) explaining about Liver cirrhosis treatment in Ayurveda. The cirrhosis can be caused by any reason - Hepatitis, Alcohol, Drugs or any other toxins.
Ayurvedic Treatment for Diabetes - Diabetes Remedy
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Ayurvedic Treatment for Diabetes - Natural Supplements
According to Ayurveda, diabetes is one of the 20 types of "Prameha Rog". There are 20 types of Prameha, 10 out of 20 prameha are called "Kaphaja" , 6 are called "pittaja" and 4 are called Vataja". The vataja prameha are difficult to treat and diabetes is one of those vataja prameha. This is also known as Madhumeha
In Ayurveda it is also mentioned that if any type of Prameha is not take care well properly, they change into Madhumeha.
The cause of Madhumeha - Diabetes Causes - Type 2 diabetes causes -
Sedentary life style, genetic causes, Chronic stress and anxiety, too much high calorie food intake at regular intervals, no physical exercise, lack of sleep or irregular sleep are one of the reasons for type 2 diabetes.
AYURVEDIC TREATMENT OF DIABETES
Ayurvedic treatment of Diabetes is aimed to restore the normal sugar levels using pure herbs. There are certain herbal combinations mentioned in Ayurveda which help to improve sugar control and help to prevent complications.
The classical Ayurvedic treatment of diabetes consists of using following natural remedies in the following combination -
Vasant Kusumakar Ras - 4 gm
Vrihtvatchintamani Ras -4 gm
Yashad Bhasma - 10 gm
Tapyadi Loh - 10 gm
Shilajatwadi Vati - 4 gm ( with gold)
Kalmegh Navayas Loh -10 gm
Praval Panchamrit - 10 gm
Mukta Pishti - 4 gm
Giloy Satv - 20 gm
--------------- Mix them all well, make 60 sachets of all of these, consume 1 sachet twice daily with honey.
2. Cap. Diabeta Plus - 2 twice daily
# 1 and # 2 can be used alone, in case the diabetes is just a few years old.
3. Cap. Fenugreek - 2 twice daily
4. Cap. Gymnema - 2 twice daily
From # 1 to # 4 should be used together if the diabetes is more than 10 years old
5. Cap. Bittermelon - 2 twice daily
6. Madhumehantak Churna -1 teaspoonful twice daily
7. Cap. Curcumin - 2 twice daily
# 1 to # 7 can be all used together if the patient is on Insulin and still the sugar in not in control. All these can be used and sugar levels monitored.
To prevent diabeteic neuropathy and other complications
1. Cap. Shilajit - 1 twice daily
2. Cap. Ashwagandha - 1 twice daily
All the above mentioned medicines can be used alone also, if the diabetes is less than 4 years old. Fenugreek capsules should be used to give added protection with any other herbal formula. All the diabetes formulations are available at - www.planetayurveda.com
Or can be purchased by contacting Mr. Ashwani thakur at 09915593604 ( Email - ashwani3003@gmail.com) or calling at landline -0172-5073604 ( add + 91 and remove 0 for ISD)
According to Ayurveda, diabetes is one of the 20 types of "Prameha Rog". There are 20 types of Prameha, 10 out of 20 prameha are called "Kaphaja" , 6 are called "pittaja" and 4 are called Vataja". The vataja prameha are difficult to treat and diabetes is one of those vataja prameha. This is also known as Madhumeha
In Ayurveda it is also mentioned that if any type of Prameha is not take care well properly, they change into Madhumeha.
The cause of Madhumeha - Diabetes Causes - Type 2 diabetes causes -
Sedentary life style, genetic causes, Chronic stress and anxiety, too much high calorie food intake at regular intervals, no physical exercise, lack of sleep or irregular sleep are one of the reasons for type 2 diabetes.
AYURVEDIC TREATMENT OF DIABETES
Ayurvedic treatment of Diabetes is aimed to restore the normal sugar levels using pure herbs. There are certain herbal combinations mentioned in Ayurveda which help to improve sugar control and help to prevent complications.
The classical Ayurvedic treatment of diabetes consists of using following natural remedies in the following combination -
Vasant Kusumakar Ras - 4 gm
Vrihtvatchintamani Ras -4 gm
Yashad Bhasma - 10 gm
Tapyadi Loh - 10 gm
Shilajatwadi Vati - 4 gm ( with gold)
Kalmegh Navayas Loh -10 gm
Praval Panchamrit - 10 gm
Mukta Pishti - 4 gm
Giloy Satv - 20 gm
--------------- Mix them all well, make 60 sachets of all of these, consume 1 sachet twice daily with honey.
2. Cap. Diabeta Plus - 2 twice daily
# 1 and # 2 can be used alone, in case the diabetes is just a few years old.
3. Cap. Fenugreek - 2 twice daily
4. Cap. Gymnema - 2 twice daily
From # 1 to # 4 should be used together if the diabetes is more than 10 years old
5. Cap. Bittermelon - 2 twice daily
6. Madhumehantak Churna -1 teaspoonful twice daily
7. Cap. Curcumin - 2 twice daily
# 1 to # 7 can be all used together if the patient is on Insulin and still the sugar in not in control. All these can be used and sugar levels monitored.
To prevent diabeteic neuropathy and other complications
1. Cap. Shilajit - 1 twice daily
2. Cap. Ashwagandha - 1 twice daily
All the above mentioned medicines can be used alone also, if the diabetes is less than 4 years old. Fenugreek capsules should be used to give added protection with any other herbal formula. All the diabetes formulations are available at - www.planetayurveda.com
Or can be purchased by contacting Mr. Ashwani thakur at 09915593604 ( Email - ashwani3003@gmail.com) or calling at landline -0172-5073604 ( add + 91 and remove 0 for ISD)
Swollen Lymph Nodes Ayurvedic treatment, Causes, Lymphoma
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Swollen Lymph Nodes Ayurvedic Treatment - Causes, Signs, Symptoms and natural cure with herbal remedies
There are several reasons for swelling in lymph glands. Lymph glands are actually small oval shaped glands spread all over the body. They are basically organs of immune system. The lymph nodes are full of white blood cells, Lymphocytes and macrophages. The lymph nodes are actually battle ground of the intruders ( bacteria, viruses ) and our body's army i.e. immunity. The immune cells fight with the intruders and the dead bodies keep piling up in the lymph nodes and this leads to swollen lymph glands. The lymph nodes are sometimes swollen due to infection, as explained above, but there may be so many other reasons which lead to swollen lymph nodes. These are -
Infections in the extremities, teeth, throat, jaw etc. leading the lymph nodes enlargement and swelling
Hodgkin's or non-hodgkin's lymphomas
Certain types of cancers
Common cold, skin, asthma, Measles, Mumps and many prolonged illnesses.
Herbal remdies for Swollen lymph nodes
The following combination of natural remedies offers cure of swollen lymph glands within few days of using them.
1. Cap. Ashwagandha - 2 twice daily
2. Tab. Kachnaar Guggul - 2 thrice daily
3. Cap. Curcumin - 2 thrice daily
To read more about these, click here or write to mr. ashwani at - ashwani30003@gmail.com or call him at +-91-991559-3604
There are several reasons for swelling in lymph glands. Lymph glands are actually small oval shaped glands spread all over the body. They are basically organs of immune system. The lymph nodes are full of white blood cells, Lymphocytes and macrophages. The lymph nodes are actually battle ground of the intruders ( bacteria, viruses ) and our body's army i.e. immunity. The immune cells fight with the intruders and the dead bodies keep piling up in the lymph nodes and this leads to swollen lymph glands. The lymph nodes are sometimes swollen due to infection, as explained above, but there may be so many other reasons which lead to swollen lymph nodes. These are -
Infections in the extremities, teeth, throat, jaw etc. leading the lymph nodes enlargement and swelling
Hodgkin's or non-hodgkin's lymphomas
Certain types of cancers
Common cold, skin, asthma, Measles, Mumps and many prolonged illnesses.
Herbal remdies for Swollen lymph nodes
The following combination of natural remedies offers cure of swollen lymph glands within few days of using them.
1. Cap. Ashwagandha - 2 twice daily
2. Tab. Kachnaar Guggul - 2 thrice daily
3. Cap. Curcumin - 2 thrice daily
To read more about these, click here or write to mr. ashwani at - ashwani30003@gmail.com or call him at +-91-991559-3604
DIET IN KIDNEY FAILURE - HOW TO AVOID DIALYSIS
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DIET IN KIDNEY FAILURE AND RENAL DISEASE – DIET FOR RENAL PATIENTS- DIETARY ADVICE FOR KIDNEY FAILURE PATIENTS & HOW TO AVOID DIALYSIS
The kidneys are very important organ in the body. Their action is closely related to the Nervous system and Reproductive organs. They are as important to the water metabolism as the colon is to food. Just as wrong eating habits damage the stomach on G.I.Tract, improper intake of the liquids damage the kidneys and the urinary tract.The kidneys are weakened by drinking either too much or too little water, by alcohol, by excessive sexual activity, by antibiotics and by not heeding the urge to urination. Fear and fright damage the kidneys on a psychological level. They are delicate in sensitive or traumatized children, or in anyone who has suffered stress to the adrenals. In case of Kidney failure it is very important to follow a specific diet to avoid dialysis and reduce urea and creatinine level.
KIDNEY DAMAGE DUE TO DIABETES OR BLOOD PRESSURE- HOW TO AVOID DIALYSIS USING HERBS AND NATURAL REMEDIES
Uncontrolled diabetes or blood pressure is usually the major reason behind Kidney Failure. This is a condition called Diabetic Nephropathy. In this condition, the kidney is excreting more proteins, the Urea, Creatinine levels are high, the potassium levels are high and there is a risk of electrolyte imbalance. The toxins level is raised and therefore regular dialysis is required. Dialysis is nothing but filter the whole blood through machine.There are many other reasons due to which the toxins accumulate and lodge themselves in the kidneys and urinary tract, particularly when the kidneys are not filtering the blood properly. Symptoms include lower back pain, sciatic pain, difficult or painful urination, urinary tract infections, swollen prostate or kidney stones.One should follow proper diet to avoid further complications arising from the kidney disease. One should mainly lower the sodium, fluids and protein intake.One should remember that Diabetes and Hypertension are the major cause of kidney disease. So, one should maintain normal glucose levels and normal blood pressure to maintain proper function of the kidneys.Impaired Kidneys cannot easily remove salt, potassium and water, that’s why they should be consumed in limited quantities. It is not a threat; these are steps to eat the right amount of nutrients to remain healthy.
LOWER SODIUM INTAKEAvoid intake of salt in your food. It can raise the blood pressure, risk of heart failure and pulmonary edema and so sodium intake should necessarily be lowered. Have a very low salt diet. Avoid processed foods or canned foods, pickles, cheese etc that are high in salt content. Also avoid potato chips, pizza and any kind of packaged food. It is always preferable to have homemade food.
LOWER POTASSIUM INTAKESome people with kidney disease need to lower their potassium intake. It is found naturally in many fruits and vegetables. In poor function of the kidneys, it fails to remove the excess potassium from the blood. A high level in potassium can cause muscle weakness and affect the Heart rhythm. Foods rich in potassium are salt substitutes, bananas and apricots. However salt substitutes are not advisable, because it will further aggravate the disease.
FOODS RICH IN POTASSIUM AREWheat germ, Sunflower seed, Almond, Raisin, Parsley, Lettuce, Radish, Cabbage, Dandelion root, Bananas, Water melon, Citrus fruits, Mushrooms, Greens, Spinach, Cucumber, Dried figs, Apricots, Dates, Wheat bran, Soybean, Avocado, Garlic, Tomato, Peas, Beans, Celery rootAlfalfa seeds, raw (1 cup)- 33 gApple (1)- 138 gApricot, raw (1)- 35 gAsparagus , cooked, boiled (4 spears)- 60 gBanana (1)- 118 gBeans, baked (1 cup)- 254 gCabbage, raw (1 cup)- 70 gCelery (1 stalk )- 40 gCheese (1 tbsp)- 14.5 gCucumber, peeled, raw(1 cup)- 119 gDates (5)- 41.5 gDandelion, boiled (1 cup)- 105 gGarlic, 1 clove- 3 gLettuce, 1 leaf- 10 gParsley , 10 sprigs- 10 gRadish (1)- 4.5 gRaisins (1 cup)- 145 gPeas , boiled (1 cup)- 160 gSpinach, raw (1 cup)- 30 gSoy beans, cooked ( 1 cup)- 172 gTomatoes (1)- 123 gWatermelon (1 cup)- 152 gWheat flour (1 cup)- 120 g
LOWER LIQUID INTAKEDo not have water or fluid content more than 1.5 Liters per day. Replace it with vegetables that has high water content like snake gourd, radish, spinach etc. even they come under fluid intake. But they are nutritious. Instead of merely drinking water, this can be taken. Also one can have tender coconut water (if they are not diabetic) and even buttermilk. All this should come under one and half litre per day. Have warm water instead of plain water.
LIMIT PROTEIN INTAKEProtein is very essential to sustain energy levels in the body. A healthy kidney separates protein from the wastes and excretes the wastes from the blood. While an impaired kidney also excretes the protein and causes protein loss. That’s why Doctors suggest limiting protein intake to avoid much pressure on the kidneys. Also complete elimination is not advisable. Hence limited protein intake can balance the functions of the kidneys. Choose high quality protein like chicken, lean meat, fish, eggs etc. have 160 to 190 Gms of protein per day. The quantity depends upon level of blood urea and creatinine. Usually 40-50 gm of protein intake is recommended per day.Milk (half L)-18 gYogurt (1 cup)-7 gMeat (200 g)-50 gBeans baked (1 cup)-254 gEgg (1)-8 gSoya milk (200ml)-6 gFish (100 g )-21 gCheese (100 g )-25 gRoast chicken (100 g )-25 gRoast beef (100 g )-25 gCabbage cooked (1 cup)-150 gCabbage raw (1 cup)-70 gRipe tomatoes (1 cup)-180 g
LOWER CHOLESTEROL INTAKEIntake of high fat substances or fried food items may increase the levels of cholesterol. Even if it is home-made it is not advisable to have high fat food. Increase in cholesterol level in blood can cause kidney damage or failure. Use vegetable oils like safflower oil, olive oil for cooking which are the safest and healthiest choices.AVOID SMOKINGSmoking can complicate the disease further. It has been found that it causes heart attacks and sometimes even death of a person suffering from Chronic Kidney Disease.
LIMIT PHOSPHOROUS INTAKEAvoid intake of dairy products such as cheese, butter, ice creams etc. Avoid beverages like cola, alcohol etc. avoid nuts, peas and beans. Foods that are high in phosphorous are milk, cheese, nuts and cola drinks. Too much of phosphorous will remove calcium from bones and affect the bones and may lead to osteoporosis.DIABETIC NEPHROPATHYDiabetes mellitus affects the structure and function of the Kidney in many ways. The term diabetic nephropathy encompasses all the lesions occurring in the kidneys of patients with diabetes mellitus. These lesions include glomerulo-sclerosis, arterionephro-sclerosis, chronic interstitial nephritis, papillary necrosis and various tubular lesions.
Diabetic nephropathy is associated with a variety of clinical syndromes including mild asymptomatic proteinuria, nephritic syndrome, progressive renal failure and hypertension. Glomerulo lesions are particularly common and account for the majority of the abnormal clinical findings related to the kidney.
The principal clinical manifestation of diabetic glomerular disease is proteinuria. Initially only small amounts of albumin are excreted, particularly following exercise (microalbuminuria). This amount of albumin excretion is undetectable by routine screening methods. Under ordinary circumstances, microalbuminuria develops within 10 to 15 years of the onset of hyperglycemia and usually progresses within 3 to 7 years to overt proteinuria and clinical diabetic nephropathy.
With good control of hyperglycemia and elevated blood pressure, the development of microalbuminuria can be prevented or reversed. Patients with non-insulin-dependant diabetes mellitus also may develop clinical nephropathy. Precise regulation of blood sugar (by meticulous attention to diet, exercise, and insulin dosage) may be effective in reducing the development of nephropathy. During the micro-albuminuric phase, tight metabolic control slows the rate of increase in albumin excretion, as does lowering the arterial blood pressure and dietary protein restriction. Once the nephropathy has reached the stage of overt proteinuria, aggressive management of hypertension will slow the rate of loss of renal function, but strict control of blood sugar does not seem to retard the rate of progression once overt nephropathy (proteinuria > 500mg/d) has emerged.Patient with ESRF (End stage renal failure) due to diabetic nephropathy are not ideal candidates for long term dialysis because of concomitant multiple organ dysfunction secondary to arterio-vascular disease.
An early sign of kidney damage is when your kidneys leak small amounts of a protein called micro albumin into the urine.With severe damage; the kidney excretes more amount of protein called proteinuria. More wastes build up in the blood. This damage gets worse until the kidneys fail.
PREVENTION OF KIDNEY DISEASE IN DIABETES AND BLOOD PRESSURE- HOW TO AVOID DIALYSIS
Keep your blood sugar and blood pressure under control. Also maintain normal cholesterol levels. Check it every 3 to 6 months. Exercise or have a brisk walk regularly. For diabetic patients, it is more advisable to walk in the evening around 45 minutes. Always have a healthy and balanced diet. Have low salt diet. Avoid eating outside, because the ones prepared outside, sometimes add soda to cook soon or it may be unhygienic and the oil used may not be suitable for you. So, always prefer home-made food. Have a low-salt, low-protein, low-fat and high fruit and vegetable diet. Have at least two to three cups of boiled or steamed vegetables per day. Eat fiber rich foods like whole grain bread and cereals. Eat frequent small meals. Avoid processed foods like sauces, pickles etc. Check the labels for added salt. Drink warm and filtered water. Avoid food made by using baking powder like cakes, biscuits etc. Avoid legumes, milk and dairy products, mainly cheese. Use skimmed milk in the place of whole cream milk. Limit the intake of fish and meat. Have your kidneys tested at least once in a year and if you are already suffering from Kidney failure, then the tests of urea, creatinine, electrolytes should be performed every week or 15 days. Avoid smoking and alcohol. Avoid junk foods and high fat intake, if you have diabetes and not suffering from kidney disease yet. Avoid suppression of natural urges- passing or urine or stool or sleep. Maintain proper weight according to your age and height. low-fat diet and regular exercise also will lower your risk of heart and blood vessel (cardiovascular) disease Avoid drugs such as NSAID’s (non-steroidal anti-inflammatory drugs) or even the drug to lower uric acid called Zyloric also causes Renal Failure. I have seen many renal failure patients who used this drug to reduce uric acid and were suffering from Gout. There are certain herbs like Kaishore Guggul, Gorakhmundi, Navkarshik Churna which are very useful for gout.
HOW TO AVOID DIALYSIS USING HERBS AND NATURAL REMEDIES
There are certain ayurvedic herbs which are very effective in reducing urea, creatinine levels and help to avoid dialysis. The kidney failure responds very well to these natural remedies.
The combination of herbs is called "The Revive kidneys package " and mentioned by Dr. Vikram Chauhan MD (Ayurveda ) at PLANET AYURVEDA
HERBAL REMEDIES TO AVOID DIALYSIS AND HELPFUL IN RENAL FAILURE - BY Dr. VIKRAM CHAUHAN - MD ( Ayurveda )
DIET IN KIDNEY FAILURE AND RENAL DISEASE – DIET FOR RENAL PATIENTS- DIETARY ADVICE FOR KIDNEY FAILURE PATIENTS & HOW TO AVOID DIALYSIS
The kidneys are very important organ in the body. Their action is closely related to the Nervous system and Reproductive organs. They are as important to the water metabolism as the colon is to food. Just as wrong eating habits damage the stomach on G.I.Tract, improper intake of the liquids damage the kidneys and the urinary tract.The kidneys are weakened by drinking either too much or too little water, by alcohol, by excessive sexual activity, by antibiotics and by not heeding the urge to urination. Fear and fright damage the kidneys on a psychological level. They are delicate in sensitive or traumatized children, or in anyone who has suffered stress to the adrenals. In case of Kidney failure it is very important to follow a specific diet to avoid dialysis and reduce urea and creatinine level.
KIDNEY DAMAGE DUE TO DIABETES OR BLOOD PRESSURE- HOW TO AVOID DIALYSIS USING HERBS AND NATURAL REMEDIES
Uncontrolled diabetes or blood pressure is usually the major reason behind Kidney Failure. This is a condition called Diabetic Nephropathy. In this condition, the kidney is excreting more proteins, the Urea, Creatinine levels are high, the potassium levels are high and there is a risk of electrolyte imbalance. The toxins level is raised and therefore regular dialysis is required. Dialysis is nothing but filter the whole blood through machine.There are many other reasons due to which the toxins accumulate and lodge themselves in the kidneys and urinary tract, particularly when the kidneys are not filtering the blood properly. Symptoms include lower back pain, sciatic pain, difficult or painful urination, urinary tract infections, swollen prostate or kidney stones.One should follow proper diet to avoid further complications arising from the kidney disease. One should mainly lower the sodium, fluids and protein intake.One should remember that Diabetes and Hypertension are the major cause of kidney disease. So, one should maintain normal glucose levels and normal blood pressure to maintain proper function of the kidneys.Impaired Kidneys cannot easily remove salt, potassium and water, that’s why they should be consumed in limited quantities. It is not a threat; these are steps to eat the right amount of nutrients to remain healthy.
LOWER SODIUM INTAKEAvoid intake of salt in your food. It can raise the blood pressure, risk of heart failure and pulmonary edema and so sodium intake should necessarily be lowered. Have a very low salt diet. Avoid processed foods or canned foods, pickles, cheese etc that are high in salt content. Also avoid potato chips, pizza and any kind of packaged food. It is always preferable to have homemade food.
LOWER POTASSIUM INTAKESome people with kidney disease need to lower their potassium intake. It is found naturally in many fruits and vegetables. In poor function of the kidneys, it fails to remove the excess potassium from the blood. A high level in potassium can cause muscle weakness and affect the Heart rhythm. Foods rich in potassium are salt substitutes, bananas and apricots. However salt substitutes are not advisable, because it will further aggravate the disease.
FOODS RICH IN POTASSIUM AREWheat germ, Sunflower seed, Almond, Raisin, Parsley, Lettuce, Radish, Cabbage, Dandelion root, Bananas, Water melon, Citrus fruits, Mushrooms, Greens, Spinach, Cucumber, Dried figs, Apricots, Dates, Wheat bran, Soybean, Avocado, Garlic, Tomato, Peas, Beans, Celery rootAlfalfa seeds, raw (1 cup)- 33 gApple (1)- 138 gApricot, raw (1)- 35 gAsparagus , cooked, boiled (4 spears)- 60 gBanana (1)- 118 gBeans, baked (1 cup)- 254 gCabbage, raw (1 cup)- 70 gCelery (1 stalk )- 40 gCheese (1 tbsp)- 14.5 gCucumber, peeled, raw(1 cup)- 119 gDates (5)- 41.5 gDandelion, boiled (1 cup)- 105 gGarlic, 1 clove- 3 gLettuce, 1 leaf- 10 gParsley , 10 sprigs- 10 gRadish (1)- 4.5 gRaisins (1 cup)- 145 gPeas , boiled (1 cup)- 160 gSpinach, raw (1 cup)- 30 gSoy beans, cooked ( 1 cup)- 172 gTomatoes (1)- 123 gWatermelon (1 cup)- 152 gWheat flour (1 cup)- 120 g
LOWER LIQUID INTAKEDo not have water or fluid content more than 1.5 Liters per day. Replace it with vegetables that has high water content like snake gourd, radish, spinach etc. even they come under fluid intake. But they are nutritious. Instead of merely drinking water, this can be taken. Also one can have tender coconut water (if they are not diabetic) and even buttermilk. All this should come under one and half litre per day. Have warm water instead of plain water.
LIMIT PROTEIN INTAKEProtein is very essential to sustain energy levels in the body. A healthy kidney separates protein from the wastes and excretes the wastes from the blood. While an impaired kidney also excretes the protein and causes protein loss. That’s why Doctors suggest limiting protein intake to avoid much pressure on the kidneys. Also complete elimination is not advisable. Hence limited protein intake can balance the functions of the kidneys. Choose high quality protein like chicken, lean meat, fish, eggs etc. have 160 to 190 Gms of protein per day. The quantity depends upon level of blood urea and creatinine. Usually 40-50 gm of protein intake is recommended per day.Milk (half L)-18 gYogurt (1 cup)-7 gMeat (200 g)-50 gBeans baked (1 cup)-254 gEgg (1)-8 gSoya milk (200ml)-6 gFish (100 g )-21 gCheese (100 g )-25 gRoast chicken (100 g )-25 gRoast beef (100 g )-25 gCabbage cooked (1 cup)-150 gCabbage raw (1 cup)-70 gRipe tomatoes (1 cup)-180 g
LOWER CHOLESTEROL INTAKEIntake of high fat substances or fried food items may increase the levels of cholesterol. Even if it is home-made it is not advisable to have high fat food. Increase in cholesterol level in blood can cause kidney damage or failure. Use vegetable oils like safflower oil, olive oil for cooking which are the safest and healthiest choices.AVOID SMOKINGSmoking can complicate the disease further. It has been found that it causes heart attacks and sometimes even death of a person suffering from Chronic Kidney Disease.
LIMIT PHOSPHOROUS INTAKEAvoid intake of dairy products such as cheese, butter, ice creams etc. Avoid beverages like cola, alcohol etc. avoid nuts, peas and beans. Foods that are high in phosphorous are milk, cheese, nuts and cola drinks. Too much of phosphorous will remove calcium from bones and affect the bones and may lead to osteoporosis.DIABETIC NEPHROPATHYDiabetes mellitus affects the structure and function of the Kidney in many ways. The term diabetic nephropathy encompasses all the lesions occurring in the kidneys of patients with diabetes mellitus. These lesions include glomerulo-sclerosis, arterionephro-sclerosis, chronic interstitial nephritis, papillary necrosis and various tubular lesions.
Diabetic nephropathy is associated with a variety of clinical syndromes including mild asymptomatic proteinuria, nephritic syndrome, progressive renal failure and hypertension. Glomerulo lesions are particularly common and account for the majority of the abnormal clinical findings related to the kidney.
The principal clinical manifestation of diabetic glomerular disease is proteinuria. Initially only small amounts of albumin are excreted, particularly following exercise (microalbuminuria). This amount of albumin excretion is undetectable by routine screening methods. Under ordinary circumstances, microalbuminuria develops within 10 to 15 years of the onset of hyperglycemia and usually progresses within 3 to 7 years to overt proteinuria and clinical diabetic nephropathy.
With good control of hyperglycemia and elevated blood pressure, the development of microalbuminuria can be prevented or reversed. Patients with non-insulin-dependant diabetes mellitus also may develop clinical nephropathy. Precise regulation of blood sugar (by meticulous attention to diet, exercise, and insulin dosage) may be effective in reducing the development of nephropathy. During the micro-albuminuric phase, tight metabolic control slows the rate of increase in albumin excretion, as does lowering the arterial blood pressure and dietary protein restriction. Once the nephropathy has reached the stage of overt proteinuria, aggressive management of hypertension will slow the rate of loss of renal function, but strict control of blood sugar does not seem to retard the rate of progression once overt nephropathy (proteinuria > 500mg/d) has emerged.Patient with ESRF (End stage renal failure) due to diabetic nephropathy are not ideal candidates for long term dialysis because of concomitant multiple organ dysfunction secondary to arterio-vascular disease.
An early sign of kidney damage is when your kidneys leak small amounts of a protein called micro albumin into the urine.With severe damage; the kidney excretes more amount of protein called proteinuria. More wastes build up in the blood. This damage gets worse until the kidneys fail.
PREVENTION OF KIDNEY DISEASE IN DIABETES AND BLOOD PRESSURE- HOW TO AVOID DIALYSIS
Keep your blood sugar and blood pressure under control. Also maintain normal cholesterol levels. Check it every 3 to 6 months. Exercise or have a brisk walk regularly. For diabetic patients, it is more advisable to walk in the evening around 45 minutes. Always have a healthy and balanced diet. Have low salt diet. Avoid eating outside, because the ones prepared outside, sometimes add soda to cook soon or it may be unhygienic and the oil used may not be suitable for you. So, always prefer home-made food. Have a low-salt, low-protein, low-fat and high fruit and vegetable diet. Have at least two to three cups of boiled or steamed vegetables per day. Eat fiber rich foods like whole grain bread and cereals. Eat frequent small meals. Avoid processed foods like sauces, pickles etc. Check the labels for added salt. Drink warm and filtered water. Avoid food made by using baking powder like cakes, biscuits etc. Avoid legumes, milk and dairy products, mainly cheese. Use skimmed milk in the place of whole cream milk. Limit the intake of fish and meat. Have your kidneys tested at least once in a year and if you are already suffering from Kidney failure, then the tests of urea, creatinine, electrolytes should be performed every week or 15 days. Avoid smoking and alcohol. Avoid junk foods and high fat intake, if you have diabetes and not suffering from kidney disease yet. Avoid suppression of natural urges- passing or urine or stool or sleep. Maintain proper weight according to your age and height. low-fat diet and regular exercise also will lower your risk of heart and blood vessel (cardiovascular) disease Avoid drugs such as NSAID’s (non-steroidal anti-inflammatory drugs) or even the drug to lower uric acid called Zyloric also causes Renal Failure. I have seen many renal failure patients who used this drug to reduce uric acid and were suffering from Gout. There are certain herbs like Kaishore Guggul, Gorakhmundi, Navkarshik Churna which are very useful for gout.
HOW TO AVOID DIALYSIS USING HERBS AND NATURAL REMEDIES
There are certain ayurvedic herbs which are very effective in reducing urea, creatinine levels and help to avoid dialysis. The kidney failure responds very well to these natural remedies.
The combination of herbs is called "The Revive kidneys package " and mentioned by Dr. Vikram Chauhan MD (Ayurveda ) at PLANET AYURVEDA
HERBAL REMEDIES TO AVOID DIALYSIS AND HELPFUL IN RENAL FAILURE - BY Dr. VIKRAM CHAUHAN - MD ( Ayurveda ) Thursday, September 27, 2012
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