My pneumonia saga goes on, but my blood work continues to show positive results from CAR-T. Apologies for this more detailed medical account, but several of you have been asking how all this is going.

The results of the sputum samples showed that the “flora” in my lungs was normal and not pathological. A CT-scan taken at the same time showed opacity in the lower lobes of both lungs. They also saw two very tiny nodules in my right upper lung. These nodes typically show up in about half of people getting CT-lung scans and are not cause for concern as long as I wasn’t a smoker or have a family history of lung cancer. They’ll follow up in a year, but this isn’t related to the pneumonia.

After reviewing the test results, Dr. Kwaan the Kaiser pulmonologist saw nothing alarming and felt it’s a matter of waiting it out – 6 to 8 weeks. He didn’t feel a more invasive procedure like a bronchoscopy was warranted at this time. Since antibiotics didn’t work, he suggested using over-the-counter medications to treat the symptoms of coughing and nasal dripping.

In the meantime, I was getting concerned about how much I was peeing. At Stanford, they told me to drink at least 2 liters of water a day, but that meant getting up 5-6 times a night as well as during the day. I decided to make an appointment with my primary Kaiser physician Dr. Kiang. I’m very fond of her as she has been the primary physician for both Tim and myself since 2015. When Tim and I were first referred to her, she ran a battery of baseline tests. She saw from my blood tests that I was very anemic even though I didn’t present any symptoms. She investigated further and this quickly led to a diagnosis of multiple myeloma. I distinctly remember her calling me at my Through the Looking Glass office and telling me. She said that ordinarily she would have waited to tell me the diagnosis in-person. But, she knew Tim and I were both anxious to find out the results and she wanted me to start treatment asap.

When I saw Dr. Kiang this week, she first listened to my chest and said she could definitely hear the crackling in my lungs, but said she would defer to the pulmonologist as far as treatment. I haven’t seen Dr. Kiang since several months before my CAR-T procedure at Stanford. She was fairly amazed at how much weight I’ve lost: 38 lbs and dropping. We discussed my trying to gain weight which has waned a bit since this pneumonia developed. I was gaining a few pounds until the pneumonia hit. It’s mostly knocked out my sense of taste and smell. That and the various meds I’m taking that dampen my appetite. It’s become the old adage, “Eat to Live” rather than “Live to Eat.” I’m still cooking and enjoy that part, but not so much the actual eating. After examining me, she said my prostate was slightly enlarged, but not so much as to warrant concern or more invasive procedures. She also didn't think I needed to be hydrating that much. After finding no infection from a urinalysis, she prescribed Flomax which should help decrease the number of times I have to get up to pee. I'm trying to fit taking Flomax daily into my schedule since it often makes people dizzy for a few hours. Plus, you need to take it an hour or so after your last meal, and I'm trying to spread out my meals and snacks to deal with the weight loss. For me, it works out to take Flomax not long before bedtime. The only concern is to make sure I’m steady whenever I get up in the middle of the night. My Dad always cautioned me to take a little time when sitting up in the bed before standing up to go off to the bathroom. Good advice, which he always followed himself.

Besides coughing, hacking and a drippy nose, the main issue I’m having from the pneumonia and the broken-up sleep is that I’m very exhausted a lot of the time. This is, as all my docs have underscored, a result of the pneumonia and recovering from my stint at Stanford. I could easily become a couch potato. Thankfully, I manage to take a walk almost every day (thanks Chuck!) as long as I'm in wide-open spaces and wear a mask if there's any question of too much vegetation nearby. At least the mask can be a N95 rather than my large and startling pink HEPA mask which I no longer have to use. Fortunately, I can now drive so that frees me up a bit as far as where I can go to take a walk.

Even though I don’t shoot off fireworks for July 4, I have my own botanical fireworks. These photos are some of the many epiphyllum (orchid cacti) on my deck that have bloomed over the past couple weeks. They're wonderfully night fragrant, but my nose isn't up to the task right now. It's good that these orchid cacti are taking care of themselves as I can't do any gardening for at least 6 months because of my immunocompromised state. Even though I have basic gardeners for the front and side of the house, I'm beginning to investigate having a more specialized gardener for my back yard. Until now, I've enjoyed working in the garden. I haven't wanted outside gardeners in my "special place"that I get to look out on every day. As another gardender told me, "You have one of the most intensely personal gardens I've seen." I think she was saying this partly in admiration but also maybe with a little apprehension.

I wish you all a Happy 4th, but I'm not feeling very patriotic these days -- between the state of our polarized country and the recent Supreme Court decisions. I'm so appreciative of where I live and the strong network of friends and family who counter all the negativity that's so rampant these days.