After a worrisome week and Hamada’s well considered decision not to continue with more treatments for the time being, which would now involve dialysis, we are both feeling relieved and peaceful that this huge decision is over. We have had what we believe was the final Haematology consultation today unless a miracle occurs and we have had a few of those before. So with the Doctor and lovely Nurse Tracy present, we discussed all that was needed. It was a bittersweet consultation after all these years and with the last results from the second round of Revlimid, the Paraprotein reading continues to show a drop, this time -4 bringing Hamada’s count to 12 from the recent 21.7 It is a disappointment beyond compare that the failing kidneys which were the first reason to suspect MM may well be the ending point also. Because of the suddenness of this lowering of kidney function, it is hard for me not to relate it to the Revlimid + Aspirin but I know of Revlimids great success worldwide and for some without kidney problems the lowering of the PP in just two courses really shows, that this is the drug of success for many, and it may well have continued to reduce the Myeloma load for Hamada. One point to consider is that we all know that Myeloma leeches calcium from the bones and this alone after all this time, could indeed be the single reason the kidneys are failing again.
Still time will tell and I stand by my lay/woman’s judgement that it is the Revlimid + Aspirin that has compounded the damage. Further creatinine readings may in fact show this, if there is a marked improvement  now these drugs has been removed? 
It is hard to take in the severity of how ill Hamada is when I look at him, there is no outward sign that has suddenly appeared! A tiny puffiness around his eyes but no swelling of the ankles, just a continuous need for sleep and a very tiny amount of energy. He is still eating reasonably well and always his cheerful self, dignified and eager to retain control of this beastly illness.

As he has managed before with a very low kidney function eGFR (7) at one point, survived for these past four and a half years with a eGFR never being more than 17 at the highest point. Is it then, not crazy for me to expect more months? I am aware of course that should the kidney function nosedive once more, then it would be a very short time indeed. Although we have finished all clinics now, unless there is a remarkable change in Kidney function, Hamada’s blood will still be monitored,with the first visit by the out-care renal team. A nurse will be coming here on the 25th of this month. I am now waiting for the last creatinine reading taken yesterday, maybe I am ‘clutching at straws’ but this will in the very least, be most interesting! Keep well all.