Collection yesterday was a bust; we got less than a million cells, which only put us at about three million for two days. Very disappointing. It was such a poor showing that they said there wasn't any point in doing another collection today. The good thing is that we got enough for one transplant, but we need more. We have an appointment with Dr. Lonial Tuesday to discuss our options.

Last night, Jimmy's fever was gone, his white blood count was normal and we were both having a fit to leave the hospital. At about 8:30PM they finally turned us loose. Jimmy came home and went straight to bed. He's completely physically and mentally exhausted and badly needs a break to build his strength back up before we start trying to slay the dragon again.

He hasn't lost his hair yet, although that's probably coming. He looks a little pale, a little tired, definitely a little shorter because of the collapsed vertebrae, but he looks good, amazingly like our same old Jimmy.

We have the doors to our balcony open this morning; it's so pleasant outside. There's a soft breeze, the cicadas are chirping, and there is the tiniest hint of fall in the air.

When I got back to the hospital yesterday at noon, Jimmy looked grim. Some of the early factors indicated that he was not producing many stem cells. Dr. Lonial came in, Dr. Flowers came in, hemepheresis personnel were in and out. Everyone was trying to be upbeat, saying things like " it's too early to tell yet" and "sometimes you get good results when you think you're not going to", but we could tell that they were worried. They finished up at about 2:30, and the little bag of fluid was taken to the lab to be analyzed. That would take two to three hours.

Jimmy and I were in an agony of suspense. What if we didn't get any stem cells? What if we COULDN'T get any stem cells? What would we do then? By 5 o'clock, Jimmy's jaw hurt from clenching his teeth, and I was in tears and my stomach hurt. When Dr. Flowers came in at 5:30 and told us that we had collected 2.3 million cells, we were weak with relief. That's enough (barely) to do one transplant, and we're collecting again today.

One of the hardest things about all of this has been how you live and die with every number, every test, every step forward and every step back. Every day is an emotional rollercoaster.

But to all of you who have been saying prayers for Jimmy and me: thanks, and keep it up. I think it's working.

11AM Hallelujah! We started stem cell collection this morning. And they brought the mountain to Mohammed; that is, they brought that big piece of equipment to our hospital room, and they're doing the procedure there. We were a little surprised when they started today, but it's a huge relief to get this show on the road.

It's really fascinating. There are all of these tubes coming out of the port in Jimmy's chest, connected to this machine that looks like it came out of a space ship. The blood comes out one tube and into the machine where centrifugal force separates it into different components. The stem cells are the lightest and are siphoned off and collected in a bag, and the rest goes out another tube and back into Jimmy. This goes on for 4-5 hours. Tonight they tell us how many cells we collected, and whether we will have to do it all over again, which we most certainly will have to do. It's unusual to get enough in just one try. They can do this process for up to four days, and the goal is to collect ten million stem cells.

The nurse stays with Jimmy the whole time, and Jimmy was napping when I took a break, but I'm anxious to get back. I don't want to miss anything.

Jimmy continues to have a temperature of 100-102 degrees. His blood counts remain very low. Dr. Waller (one of our outstanding doctors) decided this afternoon to have Jimmy given a blood transfusion. He hopes that by Friday the blood counts will have increased enough to start the stem cell collection. In the meantime, we will remain in the hospital in the bone marrow transplant wing, where Jimmy will receive intravenous antibiotics and the best possible care.

This morning, Jimmy spent several hours in radiology while they put in a port so that they won't have to keep looking for veins to stick the IVs into. While Jimmy was downstairs, Parker Grow (who is one of Valdosta's own, and a wonderful young physician at Emory, as is Parker's wife, Kelly) stopped by our room. Parker reassured me that, while seemingly very alarming, all of this was not particularly uncommon or unexpected. At least, that's the way I interpreted it.

I am, of course, staying with Jimmy in the hospital, sleeping on one of those lovely foldout chair things. I will only be able to write updates from the apartment. I have to get back to the hospital now, but hope that very soon will have good things to report.

Jimmy had an uncomfortable night, hurting all over, and this morning his temp was back to almost 102. His white blood count is down to .4 and we've been admitted back into the hospital. Stem cell collection is on hold.

Jimmy feels fairly well today. He is contentedly lying on the sofa watching the Barclays golf tournament, which he says seems a little dull without Tiger Woods' participation. His big fret lately is over whether the trip to the hospital this weekend has thrown off the schedule for the stem cell collection process this upcoming week. His biggest fear is that he'll be hooked up to that machine without a television when the Dogs kick off on Saturday. Georgia Bulldogs do have their priorities.

My biggie for the day has been a trip to Whole Foods, where I spent a blissful hour looking and admiring and sampling. The joys of a Whole Foods almost compensate for the frustrations of Atlanta traffic.

We were released from the hospital this morning. Jimmy feels much, much better and is in good spirits. He has finally shaved and bathed, and washed his hair, which has helped MY spirits. I told the attractive young nurse wheelchairing him to the car, "I wish you could see him when he doesn't look like a street person. Cleaned up, he's pretty cute."

Driving home from the hospital, all Jimmy could talk about was how much he wanted a big fat juicy cheeseburger from Houston's. We decided against it because he's not supposed to get in crowds, and at that point would have looked like a street person wearing a mask. When we got back to the apartment, Jamey brought him a good take-out cheeseburger, so he's happy.

The food in the hospital was BEYOND vile. Last night's entree was braised Italian shoeleather, finished with a delicate Elmer's glue reduction. For breakfast, there was cold scrambled silly putty on cardboard toast points. We survived by eating Snickers bars from the vending machine.

11AM Last night about 1AM, Jimmy asked me to rub on his shoulders because they hurt. He felt very warm and when I took his temp, it was over 102. We are instructed to call in, day or night, with anything over 100.5. They awakened the doctor, who told me to take him to the hospital, and he was admitted about 3AM, and the rest of the night was spent hooking him to an IV, doing bloodwork, etc etc. The Neupogen shots can cause all kinds of side effects, but they don't play around with fever in Jimmy's condition.

I called Jamey this morning, and he is sitting with Jimmy while I have come back to the apartment to take a shower and pick up a few things. I don't know how long they'll keep Jimmy in the hospital - I would guess at least tonight. I don't know if we're still on for the stem cell collection Monday or not.

I'm getting a small signal on my cell from our hospital room, maybe because it's on the 7th floor with a window, instead of down in the basement where we usually are. Don't call unless it's very important - I don't want to disturb Jimmy. I CAN text message and email from my phone though. By the way, I have received several lovely emails lately and they have done a lot to lift my spirits, which were pretty darn low. Thank you so much.

This has been the longest day. Jimmy has slept ALL DAY LONG. Yesterday and the day before, he was miserable. Today he says he doesn't feel so badly, just tired. No books, no golf channel, no gin rummy, just sleep. Every few hours I wake him up, try to get him to eat and drink something, and MAKE him go for a walk down the corridor and back. He has no appetite and nothing tastes good to him. He's not supposed to eat fresh fruit or vegetables during this stem cell mobilization process and he can't tolerate anything very heavy. I'm trying to get him to eat something light fairly often, soup, scrambled eggs and toast, Ensure. Our conversations today have gone like this: "Eat this." "I'm not hungry." "Tough. Eat it anyway".
We don't have to be back at the clinic until Monday morning. Jimmy isn't up to going anywhere, and I don't want to get too far from the hospital in case he has has some sort of a reaction, but I surely do wish we could go home.

Same old, same old. The chemo makes him bone tired, but the steroids make him so jittery he feels like he's about to jump out of his skin. And he is just on SO much medication. In addition to all of the usual, pain meds, anti-nausea stuff, etc, now he's on penicillin, cipro, bactrim, and acyclovir to ward off infection because the chemo has played havoc with his immune system. I had the novel experience of giving him The First Shot this morning. It's questionable who was more nervous about it, the shooter or the shootee, but we both survived.

Jimmy and I both are confident that all of this will lead to a good long remission, if not to an eventual cure. We know, too, that we will never look at anything in the same way again. We see a lot of the same people, week in and week out, at the cancer center, both patients and medical personnel, and we marvel at their courage and their compassion. There is one beautiful young couple we see from time to time. They are maybe in their late twenties, the wife so weak and frail, her husband anxiously hovering around her. They look for all the world like Ali McGraw and Ryan O'Neal in "Love Story". It breaks your heart.

8 PM Jimmy has been pretty miserable today, but it could be a lot worse. No nausea, just a relentless case of hiccups. He says he feels like he has the flu.
We've played about a zillion hands of gin rummy lately, and Jimmy usually wins. I thought his "chemo-brain" might give me a little advantage, but no such luck. He still wins.

August 20, 9PM. It has been a long day. We were at the clinic for almost twelve hours, starting at 7:30 this morning. His white cell counts were still low, only 2.2, but Dr. Lonial decided to go ahead with the cytoxin anyway. Jimmy tolerated it very well. I have to set the alarm clock for a couple of times during the night to give him some pills that help to prevent damage to his urinary tract. Then Wednesday I have to start giving him shots (Neupogen and Leukine) twice a day for seven days to stimulate his body to produce more stem cells. If all goes well, the stem cell collection will start next Monday and will take up to four days, depending on how quickly we can collect enough cells. They want to collect enough stem cells for two transplants. The cells will then be frozen and stored for if and when they are needed.
I'm going to bed. The alarm goes off in less than four hours.

August 18 (happy birthday, William!)

Three weeks ago Jimmy finished his four rounds of mollecular chemotherapy. Although his paraprotein levels (a marker for myeloma) decreased significantly, they didn't come down as far as we wanted, so Dr. Lonial has decided to schedule an infusion of cytoxin, a more conventional form of chemo. This is the bad stuff that really makes you sick and your hair fall out. This was scheduled for last Monday, but when they did the bloodwork, they discovered that his cell counts were way too low, so they stopped it and have rescheduled for this coming Monday, Aug 20.

These low blood counts probably explain why Jimmy has felt so awful lately, so weak and tired it is all he can do to get out of the bed. He woke up this morning feeling better than he has in a long time, which means that his blood cells are building back up, just in time to get knocked back down on Monday. Because he was feeling better, boredom set in with a vengeance. Around noon, with the walls closing in, we looked at each other and said, "Let's go to Highlands!" So we did. We're going to spend the night and go back to Atlanta tomorrow. It's a delicious 77 degrees here instead of the sweltering 100 that we left.

Right now our dear friend Kenny Youmans, one of Jimmy's best buddies from UGA, is sitting on the porch with him, the two of them solving all of the world's problems. It's the best medicine Jimmy could be getting.

We have two separate issues that we are dealing with in Jimmy's particular case: we have the compression fractures and the orthopedic guys, and the therapists and and the Zometa infusions to strenghten his bones. Then we have the myeloma, sneaky and insidious, and infinitely more dangerous.

Our doctor, Dr. Lonial, whom we like very much, is working with patients in clinical trials and is having some encouraging results with the combination of several new drugs, including Revlimid, Velcade and dexamethasone. Assembling Jimmy's pill boxes is like putting together a jigsaw puzzle. There are so many pills and all given at different times and on different days and I worry that I might make a mistake. Then on Tuesdays and Fridays we go in early and they take blood to test, and we wait for the results. Then we wait for the doctor to look at the results and make his assessment. Then we go to the infusion room where they hook him up to an IV and we sit there for hours while the chemicals drip drip drip into his body. With all of this sitting and waiting, you'd think it would be an ideal time to make calls or send text messages. Unfortunately, my cell doesn't get a signal in the hospital. So we sit. And sit. And sit.

August 17 A review of events as they have occurred

On March 23, while playing golf with my brother Mac and George Powell (and playing well, I might add) Jimmy had a sudden stabbing pain in his back. Thinking he had either pulled a muscle, or at worst ruptured a disc, he tried all of the usual remedies for three weeks. When the intense pain did not lessen, he went for a MRI, which revealed a compression fracture: the T12 vertebra had collapsed. While doing the MRI the technician turned to me in surprise and asked "Has your husband been in an automobile accident? His back is broken!"

When multiple myeloma was diagnosed, we didn't even know what it was. We were to learn that it is a cancer of the bone marrow. We were in complete shock; Jimmy has always been so healthy.

We went to Shands where a bone marrow biopsy confirmed the diagnosis. Wanting to explore our options, we decided to go to Emory for a second opinion. Jamey helped me get him to Atlanta where we intended to stay for one night and come home the next day. We met with the doctors, but by the end of the day, Jimmy was in such excruciating pain that they admitted him to the hospital where we stayed for three weeks. It was a nightmare. Jimmy mercifully doesn't remember a lot of it, and some of it is a blur for me too. We later learned that his back had broken in two more places, L1 and L3.

Finally, Jimmy had improved enough for us to leave the hospital, but he was still in very bad shape, could not travel, and we HAD to begin treatment for the myeloma. The Ritz Carlton in Buckhead agreed to move a hospital bed into one room and set a connecting room up as a sitting room. We stayed there for a month, and the staff was wonderful. Jimmy's back improved steadily, and we were spending a lot of time going back and forth to Emory for the cancer treatments, and we decided that it was time to graduate to an apartment. Jamey found us a corporate apartment at the Gables on East Rock Springs Road, five minutes from the hospital, and it has worked out very well.