Late last year (2009) I gave a presentation to my myeloma group on myeloma survivorship, my first four months.
My presentation commenced with my condition at diagnose and I discussed if I wanted to be a survivor.
Some of my strengths are: Positive attitude, can see the big picture, don’t get bogged down with trivia, good planning and organisational skills, a willingness to learn, a self belief that I can do anything. How I used those strengths as part of my survivorship skills was explained in the six survivorship skills I identified.
Pro-active stance: Take ownership of my illness. Before I could move forward and fight my disease I had to address issues that would hold me back.
Myeloma support group: A support system with other myeloma patients.
Team Sid: A network of practical help and support.
Create a myeloma and medical knowledge base: To take ownership of my illness I had to learn about my illness.
Maintain a positive attitude: Continue what I always do, be positive.
Create positive affirmations: Compliments a positive attitude.
My next six postings will expand upon those six survivorship skills.
Two survivorship definitions:
Stages of survivorship: Debbie Moore LBF NZ.
Acute –Begins with diagnosis and spans the time of further diagnostic and treatment effects.
Livestrong - Lance Armstrong Foundation.
Survivorship begins at diagnosis, the moment your battle with cancer begins, and continues through your treatment and beyond.
Sunday, February 28, 2010
Survivorship – The first 4 months
Wednesday, February 17, 2010
Do it sooner rather than later
Six months after my first stem cell transplant for myeloma (2001) Myra and I discussed my progress and medical future with my haematologist. All was going well, my bloods, IgG etc were normal.
We said we had intended to travel as we got older. He said “do it sooner rather than later.” Rather ominous but that’s myeloma.
He said because of my compromised immune system try to avoid long haul flights and be selective where we travel. Avoid counties with limited hygiene, over crowding and be careful of what I ate.
I was 54, still had to work for an income. Our decision was easy.
We would plan a holiday (vacation) of 2 to 3 weeks once a year. Exploring New Zealand where we live and Australia a three hour flight across the Tasman Sea.
Our themes were keep it simple, let’s have fun, let’s create some memories, lets spend quality time together while I am well.
As we have a son and daughter-in-law in Sydney we factored a few visits there.
Our Australian holidays have been:
Cairns 2003
Sunshine Coast June 2004
Gold Coast 2005
Sydney May 2006
Sydney Christmas 2006
Gold Coast to Sydney Sunshine Coast (2007)
Sydney (NRL grand Final) September 2007
Melbourne May 2009
Sunshine Coast November 2009
Australia has a warmer climate than New Zealand. We travel in May (southern hemisphere autumn/fall) when the day time temperature is about 24C (75F).
Lots of good memories.
We said we had intended to travel as we got older. He said “do it sooner rather than later.” Rather ominous but that’s myeloma.
He said because of my compromised immune system try to avoid long haul flights and be selective where we travel. Avoid counties with limited hygiene, over crowding and be careful of what I ate.
I was 54, still had to work for an income. Our decision was easy.
We would plan a holiday (vacation) of 2 to 3 weeks once a year. Exploring New Zealand where we live and Australia a three hour flight across the Tasman Sea.
Our themes were keep it simple, let’s have fun, let’s create some memories, lets spend quality time together while I am well.
As we have a son and daughter-in-law in Sydney we factored a few visits there.
Our Australian holidays have been:
Cairns 2003
Sunshine Coast June 2004
Gold Coast 2005
Sydney May 2006
Sydney Christmas 2006
Gold Coast to Sydney Sunshine Coast (2007)
Sydney (NRL grand Final) September 2007
Melbourne May 2009
Sunshine Coast November 2009
Australia has a warmer climate than New Zealand. We travel in May (southern hemisphere autumn/fall) when the day time temperature is about 24C (75F).
Lots of good memories.
Sunday, February 14, 2010
Myeloma plateau or remission
Now that I had reached my first myeloma plateau stage people were asking “what is a plateau stage”?
When I was diagnosed with myeloma in 2001 myeloma was considered a cancer that had no cure. It was explained I would have treatment, recover, then enter a plateau stage. This would be followed by a relapse, more treatment, then another plateau stage. This cycle of treatment/plateau/relapse was to be my future with the plateau stage getting progressively shorter. Treatment was chemotherapy; Thalidomide was on the horizon, that was it.
Plateau was described as a stable stage of my disease following a good response to anti cancer treatment. The word remission was not used.
It is only in recent times that the word remission has been introduced into the myeloma vocabulary. Now it is:
CR = complete remission.
VGPR = very good partial remission.
PR = partial remission.
NR = no remission.
The advent of the new generation treatments Thalidomide, Velcade, Revlimid and their alphabet combinations VTD, RTD, VPM etc, etc have changed outcomes. Improved treatment responses means people are now living longer with myeloma.
With total therapy treatment now available CR is the expected outcome. If I was a participant of total therapy treatment I would be totally focused on CR and would be telling everyone my entire goal is CR. Plateau would not be used.
My reference to plateau stage is now being challenged by myeloma treatment moving forward, it is time for me to reassess.
When I was diagnosed with myeloma in 2001 myeloma was considered a cancer that had no cure. It was explained I would have treatment, recover, then enter a plateau stage. This would be followed by a relapse, more treatment, then another plateau stage. This cycle of treatment/plateau/relapse was to be my future with the plateau stage getting progressively shorter. Treatment was chemotherapy; Thalidomide was on the horizon, that was it.
Plateau was described as a stable stage of my disease following a good response to anti cancer treatment. The word remission was not used.
It is only in recent times that the word remission has been introduced into the myeloma vocabulary. Now it is:
CR = complete remission.
VGPR = very good partial remission.
PR = partial remission.
NR = no remission.
The advent of the new generation treatments Thalidomide, Velcade, Revlimid and their alphabet combinations VTD, RTD, VPM etc, etc have changed outcomes. Improved treatment responses means people are now living longer with myeloma.
With total therapy treatment now available CR is the expected outcome. If I was a participant of total therapy treatment I would be totally focused on CR and would be telling everyone my entire goal is CR. Plateau would not be used.
My reference to plateau stage is now being challenged by myeloma treatment moving forward, it is time for me to reassess.
Monday, February 8, 2010
Interferon maintenance for myeloma
After achieving the plateau stage following my first autologous stem cell transplant for myeloma in 2001 my haematologist put me on maintenance therapy of interferon alpha.
At that time trial data suggested that interferon maintenance therapy improved remission duration in patients following transplants.
The interferon was self administered, injecting into my thigh or stomach three times a week.
Initially I suffered side effects of flu like symptoms and chills the day after the injections. These progressively reduced and disappeared after four weeks.
Eventually I began to suffer the symptoms of depression. This was attributed to the Interferon therapy. My depression was getting progressively worse so in early 2005 I stopped the Interferon and the depression disappeared.
With the introduction of the newer treatments we now have, Interferon seems to have fallen out of favour.
At that time trial data suggested that interferon maintenance therapy improved remission duration in patients following transplants.
The interferon was self administered, injecting into my thigh or stomach three times a week.
Initially I suffered side effects of flu like symptoms and chills the day after the injections. These progressively reduced and disappeared after four weeks.
Eventually I began to suffer the symptoms of depression. This was attributed to the Interferon therapy. My depression was getting progressively worse so in early 2005 I stopped the Interferon and the depression disappeared.
With the introduction of the newer treatments we now have, Interferon seems to have fallen out of favour.
Thursday, February 4, 2010
Myeloma wish list
I have been thinking. What would be most helpful to make life better for myeloma patients? Here are some of my thoughts.
USB port:
It’s the era of computer development so why weren’t we born with a USB port some where on our body. Plug a lead from the port to the computer and through a computer programme we could diagnose, read all blood results and determine anything else that was wrong. If the programme was smart enough it could even do a bone marrow biopsy.
That would do away with finding veins.
Car park building ticket:
Ever tried to put your arm out the car window to get the ticket from the car park ticket machine while suffering myeloma bone pain? Sometimes I had to ask Myra to get out of the passenger seat and walk around to get the ticket out of the machine for me. I want an arm on that machine that extends into the car so I don’t have to reach out.
Speed humps:
Speed humps should be made from soft foam rubber that would help the bones!!!
Showering:
Showering with myeloma bone pain and restricted movement is difficult. I need a showering machine like a car wash. Turn it on, walk in and let the brushes and rollers do the work.
Plumbing inlet/outlet.
Needles in veins for blood tests and IV lines could be avoided it we were born with permanent inlet outlet taps connected directly to a vein.
Electronic bed:
That’s already available and I have used one, a great help. During my second ASCT I had an arm in a sling and was suffering myeloma back pain. The hospital gave me the electronic bed complete with remote control. Move it up, move it down, raise the head, raise or lower the legs.
USB port:
It’s the era of computer development so why weren’t we born with a USB port some where on our body. Plug a lead from the port to the computer and through a computer programme we could diagnose, read all blood results and determine anything else that was wrong. If the programme was smart enough it could even do a bone marrow biopsy.
That would do away with finding veins.
Car park building ticket:
Ever tried to put your arm out the car window to get the ticket from the car park ticket machine while suffering myeloma bone pain? Sometimes I had to ask Myra to get out of the passenger seat and walk around to get the ticket out of the machine for me. I want an arm on that machine that extends into the car so I don’t have to reach out.
Speed humps:
Speed humps should be made from soft foam rubber that would help the bones!!!
Showering:
Showering with myeloma bone pain and restricted movement is difficult. I need a showering machine like a car wash. Turn it on, walk in and let the brushes and rollers do the work.
Plumbing inlet/outlet.
Needles in veins for blood tests and IV lines could be avoided it we were born with permanent inlet outlet taps connected directly to a vein.
Electronic bed:
That’s already available and I have used one, a great help. During my second ASCT I had an arm in a sling and was suffering myeloma back pain. The hospital gave me the electronic bed complete with remote control. Move it up, move it down, raise the head, raise or lower the legs.
Monday, February 1, 2010
Central vein occlusion again
A month after finishing my final VAD cycle for myeloma and 2 days after my stem cell harvest (2001) I developed blurred vision in my left eye resulting in a mild central vein occlusion. A previous posting of mine covered that.
Link: Left central vein occlusion.
Three and a half years later (April 2005) I developed blurred vision in my right eye.
This occurred during my first plateau stage. Two months earlier I had stopped taking Interferon Alpha-2A maintenance treatment. At the time of the blurred vision I was on no medication, all my test results were normal. An appointment was made to see the eye clinic at the hospital where the eye was inspected and tests were carried out.
The left eye (previous central vein occlusion) showed “no signs of the previous vascular event.”
The right eye presented a “swollen optic nerve with tortuous veins and numerous nerve fibre layer haemorrhages. There was diffuse macular oedema.”In simple terms the right eye showed a mild central vein occlusion.
No treatment was required and I was advised that over the next 3 months my vision would either improve or deteriorate. My right eye improved and returned to normal. As a precaution my hematologist prescribed a daily low dose aspirin (Cartia) to help thin the blood which I continue to have.
A follow up 9 months later showed that the right eye had returned to its normal state.
I have had no eye problems since.
Link: Left central vein occlusion.
Three and a half years later (April 2005) I developed blurred vision in my right eye.
This occurred during my first plateau stage. Two months earlier I had stopped taking Interferon Alpha-2A maintenance treatment. At the time of the blurred vision I was on no medication, all my test results were normal. An appointment was made to see the eye clinic at the hospital where the eye was inspected and tests were carried out.
The left eye (previous central vein occlusion) showed “no signs of the previous vascular event.”
The right eye presented a “swollen optic nerve with tortuous veins and numerous nerve fibre layer haemorrhages. There was diffuse macular oedema.”In simple terms the right eye showed a mild central vein occlusion.
No treatment was required and I was advised that over the next 3 months my vision would either improve or deteriorate. My right eye improved and returned to normal. As a precaution my hematologist prescribed a daily low dose aspirin (Cartia) to help thin the blood which I continue to have.
A follow up 9 months later showed that the right eye had returned to its normal state.
I have had no eye problems since.
Monday, January 25, 2010
The corridor
To reach my haematology day stay appointment at Auckland hospital I went up a lift, out into a lobby then turned right into a long corridor about 50 meters long (USA 46 yards). When walking that corridor prior to an appointment it was natural to be apprehensive. The corridor was long, giving one time to ponder.
After the second month I was responding well to treatment, test results were changing for the better, my way forward was working. That gave me a positive feeling when leaving the appointment.
After successful results the long walk back down the corridor was used to celebrate success. I would glance at Myra; my face would break into a big smile, with my arms pumping into the air I would say “yes, yes, yes”. A couple of times after my bones had mended I jumped up to click my heals.
After the second month that corridor had more good memories for me than bad.
A couple of years later during my plateau stage the day stay was integrated into a new building, the long corridor was no more.
The corridor remains as one of my early myeloma memories.
After the second month I was responding well to treatment, test results were changing for the better, my way forward was working. That gave me a positive feeling when leaving the appointment.
After successful results the long walk back down the corridor was used to celebrate success. I would glance at Myra; my face would break into a big smile, with my arms pumping into the air I would say “yes, yes, yes”. A couple of times after my bones had mended I jumped up to click my heals.
After the second month that corridor had more good memories for me than bad.
A couple of years later during my plateau stage the day stay was integrated into a new building, the long corridor was no more.
The corridor remains as one of my early myeloma memories.
Friday, January 22, 2010
Coping with death of a myeloma friend
Three months after my first stem cell transplant (2001) I experienced the first of my myeloma friends dying, death from myeloma.
Myeloma is a cancer which has no cure. At that time in New Zealand prognosis was 3 years, possibly up to 5 years with an ASCT, standard treatment was chemotherapy, thalidomide had not been approved. Death from myeloma was a reality.
Not long after diagnose I went through the process of confronting death. For me to move forward death could not be avoided; there was to be no denial.
Link: Confronting death from myeloma.
When I heard that “J” had died from the consequences of myeloma I was devastated, very distraught. “J” was a mentor to me, helping me from our first meeting at our myeloma support group with coping skills, myeloma, and transplant advice. In 1995 he had been ASCT patient No 4 in New Zealand, a myeloma and ASCT pioneer.
During the previous 3 months I had been very much focussed on me, my ASCT preparation, transplant and recovery. This left me with little time for anything else; I had forgotten that people die of myeloma.
The death of “J” jolted me back to reality.
Unable to cope adequately I approached the Cancer Society of NZ for counselling, a service I had used before not long after diagnose. My counsellor listened to me explain my problem, we discussed the situation then I was introduced to a range of coping skills. It was up to me to decide what would suit me.
From that counselling I have devised a routine that I use when a myeloma friend dies.
Myeloma can be such a selective and personal disease affecting us all differently.
One of my original sayings is repeated: “My illness, my body, my medication.” My myeloma friend has died, not me. My battle continues.
I sit alone and reminisce about my myeloma friend, their illness, the good times, the bad times, what they meant to me and the times we shared. At the conclusion of that I say the first of my farewells.
Next I ask Myra to sit with me, she usually knows the person. We talk together then say goodbye to our friend ending with a prayer.
The final step is to fill in a bereavement card and include a small note to the family. Only when I feel I have fully dealt with the death do I seal and post the card. That is the final farewell.
My myeloma friends mean a lot to me, they are my lifeline. In a corner of my heart I place a red rose for each one who has passed on. Rest in peace my myeloma friends.
John 5:24 “I tell you the truth, whoever hears my word and believes him who sent me has eternal life and will not be condemned; he has crossed over from death to life.”
Myeloma is a cancer which has no cure. At that time in New Zealand prognosis was 3 years, possibly up to 5 years with an ASCT, standard treatment was chemotherapy, thalidomide had not been approved. Death from myeloma was a reality.
Not long after diagnose I went through the process of confronting death. For me to move forward death could not be avoided; there was to be no denial.
Link: Confronting death from myeloma.
When I heard that “J” had died from the consequences of myeloma I was devastated, very distraught. “J” was a mentor to me, helping me from our first meeting at our myeloma support group with coping skills, myeloma, and transplant advice. In 1995 he had been ASCT patient No 4 in New Zealand, a myeloma and ASCT pioneer.
During the previous 3 months I had been very much focussed on me, my ASCT preparation, transplant and recovery. This left me with little time for anything else; I had forgotten that people die of myeloma.
The death of “J” jolted me back to reality.
Unable to cope adequately I approached the Cancer Society of NZ for counselling, a service I had used before not long after diagnose. My counsellor listened to me explain my problem, we discussed the situation then I was introduced to a range of coping skills. It was up to me to decide what would suit me.
From that counselling I have devised a routine that I use when a myeloma friend dies.
Myeloma can be such a selective and personal disease affecting us all differently.
One of my original sayings is repeated: “My illness, my body, my medication.” My myeloma friend has died, not me. My battle continues.
I sit alone and reminisce about my myeloma friend, their illness, the good times, the bad times, what they meant to me and the times we shared. At the conclusion of that I say the first of my farewells.
Next I ask Myra to sit with me, she usually knows the person. We talk together then say goodbye to our friend ending with a prayer.
The final step is to fill in a bereavement card and include a small note to the family. Only when I feel I have fully dealt with the death do I seal and post the card. That is the final farewell.
My myeloma friends mean a lot to me, they are my lifeline. In a corner of my heart I place a red rose for each one who has passed on. Rest in peace my myeloma friends.
John 5:24 “I tell you the truth, whoever hears my word and believes him who sent me has eternal life and will not be condemned; he has crossed over from death to life.”
Tuesday, January 19, 2010
Soft tissue plasmacytoma
I was diagnosed with myeloma stage III IgG Kappa in 2001.
Link to Summary June 2001 to January 2009.
Last year May 2009 my IgG levels rose and I developed 2 soft tissue plasmacytoma in the skin on my skull. No pain, tenderness, headaches or discomfort just 2 lumps. A fine needle biopsy confirmed what they were.
Treatment was 4 months of cyclophosphamide and dexamethasone. This reduced the IgG back into the normal range and the two soft tissue plasmacytoma disappeared.
Unfortunately in November 2009 the two soft tissue plasmacytoma reappeared and a decision was made to treat them with radiation. IgG has risen slightly but staying within the normal range.
There will be 5 days of radiation started on Monday, a shallow blast allowing my brain cells to remain undisturbed. I will likely loose my hair permanently where the radiation is applied. Unlike chemotherapy where the hair grows back radiation kills the hair follicles.
Last week I had my two soft tissue plasmacytoma measured to create a template for a lead cover with a hole in it to be placed over my skull during radiation.
One soft tissue plasmacytoma is at the front of my skull, slightly to the left but still within the hairline measuring 5cm (2 inches) diameter by 2cm (3/4 inch) high.
The second is at the rear of my crown on the right hand side measuring 7cm by 5 cm (2-3/4 inches by 2 inches) and 1cm (3/8 inch) high.
There are two worrying aspects of my soft tissue plasmacytoma.
First is cosmetic. I am a 62 year old male with a reasonable crop of hair, receding a little and minor thinning on top. To suddenly have two large bald spots in 2 random places is a blow to my pride. Time for a deep breath, short hair cut, find new headwear other than a cap and move on.
Second is why is this suddenly happening to me and why on my skull? Is this a reaction to the accumulative effect of my treatment over the years? Will there be any more after these have been destroyed? Questions for my haematologist.
It has been difficult to find information on soft tissue plasmacytoma in the skull skin on the internet, the best I have found is here: Link to plasmacytoma overview.
Some notes from that link are:
Solitary plasmactomas can be divided into 2 groups according to location.
Plasmacytoma of the skeletal system (SBP) i.e. in the bones.
Extramedullary plasmacytoma (EMP) i.e. in the tissues outside of the bones.
Although extramedullary plasmacytoma (EMP) can occur in any site, 80-90% of tumours develop in the head and neck area, especially in the aero digestive tract.
Three fourths of extramedullary plasmacytoma (EMP) cases involve males.
Based on the documented radiation sensitivity of plasma cell tumours, the accepted treatment is radiotherapy.
Link to Summary June 2001 to January 2009.
Last year May 2009 my IgG levels rose and I developed 2 soft tissue plasmacytoma in the skin on my skull. No pain, tenderness, headaches or discomfort just 2 lumps. A fine needle biopsy confirmed what they were.
Treatment was 4 months of cyclophosphamide and dexamethasone. This reduced the IgG back into the normal range and the two soft tissue plasmacytoma disappeared.
Unfortunately in November 2009 the two soft tissue plasmacytoma reappeared and a decision was made to treat them with radiation. IgG has risen slightly but staying within the normal range.
There will be 5 days of radiation started on Monday, a shallow blast allowing my brain cells to remain undisturbed. I will likely loose my hair permanently where the radiation is applied. Unlike chemotherapy where the hair grows back radiation kills the hair follicles.
Last week I had my two soft tissue plasmacytoma measured to create a template for a lead cover with a hole in it to be placed over my skull during radiation.
One soft tissue plasmacytoma is at the front of my skull, slightly to the left but still within the hairline measuring 5cm (2 inches) diameter by 2cm (3/4 inch) high.
The second is at the rear of my crown on the right hand side measuring 7cm by 5 cm (2-3/4 inches by 2 inches) and 1cm (3/8 inch) high.
There are two worrying aspects of my soft tissue plasmacytoma.
First is cosmetic. I am a 62 year old male with a reasonable crop of hair, receding a little and minor thinning on top. To suddenly have two large bald spots in 2 random places is a blow to my pride. Time for a deep breath, short hair cut, find new headwear other than a cap and move on.
Second is why is this suddenly happening to me and why on my skull? Is this a reaction to the accumulative effect of my treatment over the years? Will there be any more after these have been destroyed? Questions for my haematologist.
It has been difficult to find information on soft tissue plasmacytoma in the skull skin on the internet, the best I have found is here: Link to plasmacytoma overview.
Some notes from that link are:
Solitary plasmactomas can be divided into 2 groups according to location.
Plasmacytoma of the skeletal system (SBP) i.e. in the bones.
Extramedullary plasmacytoma (EMP) i.e. in the tissues outside of the bones.
Although extramedullary plasmacytoma (EMP) can occur in any site, 80-90% of tumours develop in the head and neck area, especially in the aero digestive tract.
Three fourths of extramedullary plasmacytoma (EMP) cases involve males.
Based on the documented radiation sensitivity of plasma cell tumours, the accepted treatment is radiotherapy.
Saturday, January 16, 2010
My veins
A consequence of a blood cancer like myeloma is many blood tests are required.
My veins are not too good, small and hard too find. This creates problems for the vampires, oops nurses, who need to extract my blood.
I go to the local Labtest, previously Med Lab, to extract my blood for tests and have found it helps me to have the same nurse each time as she becomes familiar with my veins and I become confident with her and relaxed.
On appointment day if it’s a cold day I wear gloves to keep my hands warm. Advice from the nurses to help me has included keep the fluids up to avoid dehydration, drink a glass of water on arrival, try a heated wheat bag or hot water bottle on the arms and wear clothes that keep me warm.
To increase the blood flow I keep my veins pumped up by doing hand, finger and arm exercise, mainly flexing. Some people must think I have been let out of the cupboard for the morning as there have been a few strange looks in the waiting room while doing that.
Holding my tongue to the left and closing one eye does not help at all.
When I go to haematology day stay for my monthly Aredia (bisphosphonate) I require an intravenous line in the top of my hand. The visit starts with a drink of water then a soaking of my arms in a large tub of hot water. Again I usually get the same nurse.
Speaking to other patients, apparently bad veins are not uncommon. A young lady in her late teens once told me she some times has to have the blood taken from a vein in her ankle!
I have never had any problems with fear of needles, I have very little fear. It doesn’t matter if I look at the needle going in or look away. I do like to keep my arm or hand relaxed, that does make a difference to me.
Bang, did you here that, some one has fainted reading this. As I wrote “In Helpful hints for myeloma survival” needles come with the myeloma package, overcome the fear.
My veins are not too good, small and hard too find. This creates problems for the vampires, oops nurses, who need to extract my blood.
I go to the local Labtest, previously Med Lab, to extract my blood for tests and have found it helps me to have the same nurse each time as she becomes familiar with my veins and I become confident with her and relaxed.
On appointment day if it’s a cold day I wear gloves to keep my hands warm. Advice from the nurses to help me has included keep the fluids up to avoid dehydration, drink a glass of water on arrival, try a heated wheat bag or hot water bottle on the arms and wear clothes that keep me warm.
To increase the blood flow I keep my veins pumped up by doing hand, finger and arm exercise, mainly flexing. Some people must think I have been let out of the cupboard for the morning as there have been a few strange looks in the waiting room while doing that.
Holding my tongue to the left and closing one eye does not help at all.
When I go to haematology day stay for my monthly Aredia (bisphosphonate) I require an intravenous line in the top of my hand. The visit starts with a drink of water then a soaking of my arms in a large tub of hot water. Again I usually get the same nurse.
Speaking to other patients, apparently bad veins are not uncommon. A young lady in her late teens once told me she some times has to have the blood taken from a vein in her ankle!
I have never had any problems with fear of needles, I have very little fear. It doesn’t matter if I look at the needle going in or look away. I do like to keep my arm or hand relaxed, that does make a difference to me.
Bang, did you here that, some one has fainted reading this. As I wrote “In Helpful hints for myeloma survival” needles come with the myeloma package, overcome the fear.
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