Living with multiple myeloma in the age of Covid

2021-11-25 06:16:08 By : Ms. Candy Wong

For most of his adult life, Clarence Thomas called himself a "gym rat." 

"I exercise religiously and never absent," said the 58-year-old Pembroke Pines resident, whose 6-foot, 3-inch, and 220-pound physique is a testament to his discipline and dedication. 

As the manager of Broward County Public Utilities Company, he also "never got sick" or missed any time. 

Therefore, in November 2018, when Thomas started to feel pain in his shoulder blades, he thought he "may just be straining something during training." 

He endured the pain for a while, but after a few months the pain did not go away, he went to a walk-in clinic to take X-rays. 

"They diagnosed my scapula fracture and told me to wear a shoulder strap for a few weeks." 

By March 2019, Thomas' pain had not subsided, so he went to see an orthopedic doctor, and he took more X-rays, saying that there was no scapula fracture.

Thomas and the orthopedic doctor couldn't explain the pain, so Thomas decided to do what he did when his body was injured all his life: "Treat it conservatively and ignore the pain as much as possible — instead of complaining about it." 

For the next year and a half, he kept doing this—even continuing to exercise—and the pain was getting worse. 

By late August 2020-at the height of the pandemic-his back pain had reached the point where he returned to the orthopedic doctor for more X-rays and MRIs. 

Thomas’ orthopedist took a look at the MRI and saw obvious black spots on Thomas’ lower spine bones—and knew exactly what caused Thomas’ back pain: “He told me I had cancer—multiple myeloma. " 

Thomas said that he knew the term "multiple myeloma" because "my daughter went to medical school in Los Angeles and she met patients." 

A blood test performed by Thomas' attending doctor confirmed this diagnosis in October 2020-which means that his journey of suffering from the disease that the late Colin Powell suffered from complications of COVID last month has just begun.

Approximately 30,000 Americans are diagnosed with multiple myeloma each year.

According to Dr. Chakra Chaulagain, director of the Weston Multiple Myeloma Program at the Cleveland Clinic, “Multiple myeloma is a cancer that originates from plasma cells in the bone marrow and is usually part of our immune system. Normal, healthy plasma cells will The production of immunoglobulins helps us fight infections. But malignant-or myeloma-plasma cells can produce abnormal immunoglobulins or'paraproteins', which can cause damage to the kidneys," he said. 

In addition, Chaulagain pointed out, "Due to malignant plasma cell dysfunction, immunodeficiency and immune dysfunction are associated with multiple myeloma. This makes patients vulnerable to various infections, including pneumonia." 

Therefore, when it comes to the complications of COVID, anyone with multiple myeloma is at a particularly high risk. 

Thomas' case also illustrates the need for regular blood tests. 

"I admit that I rarely go to the doctor for an annual'health' check, because I have never been sick," Thomas said. 

As Chaulagain explains, “Patients with multiple myeloma usually present with bone pain or back pain, and blood cell counts may show anemia. In addition, blood chemistry assessments may show high calcium levels and abnormal kidney function. Bone damage is common in patients with multiple myeloma. And kidney damage. Therefore, X-rays, MRI and PET scans are often included in the diagnosis process to assess evidence of bone damage." 

In fact, before Thomas started treating multiple myeloma, he had to undergo two neurospine surgeries in November and December 2020 to reconstruct the bones of the fractured lower back. 

Thomas believes that since he was in very good physical condition before the operation, he tolerated the operation relatively well and recovered quickly. 

"I feel bionic now," he said. 

Thomas received chemotherapy at the Cleveland Clinic Weston in January and February, and was considered "remission" in March. 

However, the treatment process is very difficult. 

"I lost a lot of weight, to 178 pounds," he said. 

His daughter and one of his sisters stayed with him to help him through the worst. 

Because Thomas was relatively young and in good health, he received an autologous stem cell transplant at the University of Miami in April. 

“For patients younger than 75 years of age and in good health, autologous stem cell transplantation is usually an option, which means that they do not have serious heart or kidney disease,” explains Chaulagain. "Compared with patients who did not receive autologous stem cell transplantation, in addition to initial immunotherapy and subsequent post-transplant maintenance treatment, the survival rate of patients who received autologous stem cell transplantation has improved. This is the recovery that is damaged by multiple myeloma. One of the strategies of immune function." 

Thomas thinks he is particularly lucky because his treatment coincides with a clinical trial of a new chemoimmunotherapy drug for multiple myeloma in Weston at the Cleveland Clinic. 

These drugs-daratumumab and isatuximab-have recently received approval from the U.S. Food and Drug Administration. 

"The approval of the immunotherapeutic drugs daratumumab and isatuximab for the treatment of multiple myeloma is a milestone, and it has completely changed the way we treat multiple myeloma for patients of all ages today," Chaulagain said. "The side effects are small, the effect is very good, the treatment is tolerable, and the impact on the patient's quality of life is small." 

Thomas can certainly prove the efficacy of these drugs: "I feel good these days." 

In other words, Thomas still must take extra precautions to ensure his continued health. Because of his weakened immune system, he avoids staying indoors with strangers, nor does he go anywhere without a mask. Until recently, his doctor agreed to receive COVID vaccination. 

Due to the preparations required for autologous stem cell transplantation, he pointed out that "I will have to re-vaccinate all my childhood vaccines." 

Although Thomas’ health throughout his life was the reason he avoided annual check-ups—so he lived with multiple myeloma pain for two years—but it also allowed him to quickly recover and put the disease under control. 

During his cancer journey, Thomas only let a few people know about his illness. 

In fact, his 80-something-year-old mother in his hometown of British Virgin Islands still doesn't know what happened to her son. 

"I don't want her to worry," he said shyly. 

But the reason he is sharing his story now is that he doesn't want others to repeat his mistakes and suffer unnecessary pain-especially when the disease is now very controllable. 

"Don't do like I do-see a doctor regularly and have blood tests once a year."