At the end of 2018, Ms. Liu felt a little waist pain.
She didn't take it seriously. Ms. Liu, who is less than 50 years old, is in charge of party building in the unit, often writing a lot of materials; usually loves sports, likes long-distance running, plays table tennis three times a week, and it is normal to think about it when she is in pain. This time the low back pain was not a serious disease, so she went to the hospital outpatient clinic to see a doctor, and was quickly diagnosed with lumbar muscle strain, and did physiotherapy with drugs to treat together.
The bones are sore, but they have been diagnosed with blood tumors
In March, the waist hurt even more, and in March, it even worsened to the point that the entire chest ribs hurt, and when I sneezed, I felt that the bones were about to break. The director of the physical therapy department was experienced and felt that such pain might not be just a bone problem, so he asked her to do an enhanced CT and magnetic resonance, and the doctor found that the bone was destroyed, and there were two compression fractures, and felt that the blood problem was highly suspected, so she was transferred to the hematology department.
Photo: Ms. Liu underwent more than two months of treatment in the department of pain and orthopedics before being referred to the department of hematology
After bone puncture in the hematology department, Ms. Liu had multiple myeloma.
As the name suggests, multiple myeloma refers to the plasma cells in the bone marrow, that is, the B lymphocytes that develop to the final stage, and the tumor disease formed by cancerous transformation. Cancerous plasma cells release large amounts of monoclonal immunoglobulins (also known as M proteins) into the bloodstream, causing damage to tissues throughout the body. The initial symptoms of this disease are not obvious, so it is often found in the middle or even later; and immunoglobulins circulate throughout the body with blood circulation, and there are many clinical manifestations.
Multiple myeloma may destroy bone mass and cause pathological fractures, Ms. Liu is a typical case; may inhibit the hematopoietic function of bone marrow leading to anemia; may also lead to hepatosplenial enlargement, proteinuria; there may also be amyloid changes, tongue, skin, heart, gastrointestinal tract and other parts are more common; and may even erode the nervous system, resulting in limb paralysis, drowsiness, diplopia, vision loss.
Therefore, patients with multiple myeloma often go to the symptomatic department for the first diagnosis, nephrology, orthopedics, cardiology, neurology, and even come to the hematology department for a long time, Ms. Liu's situation of turning around is not uncommon. In China, the incidence of multiple myeloma accounts for 12% to 15% of hematologic malignancies, which has become the second highest incidence of blood malignant diseases in mainland China, but most patients have never heard of it until the day they are diagnosed.
After Ms. Liu was diagnosed, the doctor did not tell her at the first time, but first invited her husband into the office to talk; but most people also knew that the situation was not optimistic when they saw this posture, and it might not be good to hide it, so after her husband came out of the doctor's office, the doctor also came out, and the three of them talked together. Talking about it, Ms. Liu's mentality was a bit broken: "You say that this is called cancer of the blood system, how can you get cancer?" I usually don't exercise less, huh? Don't you still have a table tennis run three times a week? ”
The cause of multiple myeloma is still unknown, and may be related to genetics, or long-term exposure to harmful chemicals or high doses of radiation, which is not entirely certain. However, the doctor determined that Ms. Liu's illness could be cured, which made her feel relieved. Ms. Liu didn't have much time to collapse and needed to start her anti-cancer journey immediately.
Literally "lying down for a month"
The first step in the anti-cancer journey was to move the ward, and Ms. Liu was officially admitted to the hematology ward and lay here for a whole month. This is literally "lying down for a month", and the bed can't get up. First of all, she found a fracture on her spine, and the doctor would not let her get out of bed; secondly, her back hurt so badly that she could not get out of bed, so she had to hire a 24-hour nurse to take care of her eating and drinking Lasa. And she also had to undergo chemotherapy, the side effects were not small, no strength and no appetite, the skin of her feet fell down. When the pain is uncomfortable, you have to take painkiller tablets.
Pictured: Guo Jingming, director of the Department of Hematology of Yichang Central People's Hospital in Hubei Province, explained the condition to Ms. Liu
Those who have been hospitalized in the family know that not only the patient suffers from hospitalization, but also the family members will be tired. During the treatment, Ms. Liu's husband stayed in the hospital with her clothes. His own health is not very good, this has been escorted for several months, once running upstairs and downstairs, suddenly had a heart attack, fortunately in the rescue in time to recover well.
In this way, in the interweaving of painkillers and chemotherapy, Ms. Liu spent the earliest month and was finally able to sit up from bed; then after another month, a total of two courses of treatment came down before being discharged home. At the end of the four courses, Ms. Liu's uncomfortable feelings basically disappeared.
Like most hematologic malignancies, multiple myeloma is difficult to completely eradicate. Some patients will choose hematopoietic stem cell transplantation, but regardless of the treatment, patients will need to take the drug for life. Ms. Liu was in this situation, she had a transplant in June 2020, but then she was a little slack in taking medicine, and she did not take medicine for three months, and unfortunately relapsed in June 2021.
Recurrence of multiple myeloma is not only physically affected, but also mentally. Ms. Liu just thought a lot when she diagnosed the recurrence: she felt that so much suffering in front of her had been eaten in vain, and the sins had been suffered in vain, and she felt that her disease must have a very high degree of danger, and she would recur so quickly, and she felt hopeless psychologically... During the epidemic period, it is inconvenient to enter the hospital for treatment, but fortunately there is a choice of oral medicine, and I insist on taking medicine regularly according to the doctor's advice, and gradually control the disease.
Standardized treatment is extremely important
Multiple myeloma is more common in older people. Of the three patients we visited, Ms. Liu, 53, was the youngest, and the other two were Mr. Nie, 78, and Mr. Fan, 71, whose diagnosis was no less than that.
In May and June 2018, Mr. Nie felt that the cervical spine was always painful, and ran to the hospital for massage treatment for more than a month, the effect was always not obvious, and he did not rest assured, he dragged it. The more he dragged on, the more painful it became, and by October 2019, as soon as he extended his right hand to reach something and his right ribs hurt badly, as if the inside of his body was injured, and going to the chest department still couldn't solve the problem. After another month, once he stood up straight enough, suddenly heard a "click", found that there were two ribs with the breathing up and down particularly obvious, but also severe pain, visually broken bones. The orthopedic doctor has experience, and after giving treatment, he suggested that he go to the hematology department to see, and after the examination, the diagnosis was confirmed.
The standard treatment regimen for multiple myeloma is a combination of three or four drugs, each with its own sequence, each with its own cycle, and each with its own effect. During Mr. Nie's treatment, he ate one at 8:00 in the morning and the other two at 5:30 in the afternoon; some drugs inhibited M protein, some improved immunity, and some supplemented calcium to enhance bone nutrition...
Mr. Nie, 78, was stunned to remember them all in his heart, and memorized them with a little precision in the interview. He himself said: "This disease is a chronic disease, treatment cooperates with doctors, and doctors say what to do, just do it." This kind of compliance with the doctor's advice is particularly good among patients, he laughs to himself, "This is called a long illness." In addition to taking medicine, his other aspects of compliance are also very good, sometimes need to cooperate with the doctor to draw bone marrow test, many patients scream in pain, he not only does not say a word, but also comforts the doctor to say that it is not painful. The medical staff of the whole department especially liked him and thought he had a lot of positive energy.
In contrast, Mr. Fan, 71, has taken few detours. He has always had diabetes, and in June 2021, he suddenly felt that he had no strength to go to the hospital for a review, and it turned out that the creatinine was a little high, so he went to the nephrology department. Nephrology medication quickly lowered the creatinine, but it was impossible to find the cause of the increase in creatinine. The attending doctor suggested that he transfer to a department to find the root cause of the disease, so he transferred to the hematology department and did a bone marrow puncture to confirm the diagnosis.
Pictured: Mr. Fan regularly goes to the hospital for re-examination
Mr. Fan is lucky, the family is very supportive of his treatment, never because of economic problems; his own mentality is also particularly good, living habits are maintained very well, healthy diet, tobacco and alcohol are not sticky, at the same time after meals will walk for half an hour to an hour, but also often read Tang poems and Song Ci, and even create some of his own, which has a great role in promoting the recovery of his disease.
Multiple myeloma has the characteristic that it requires long-term treatment and may require dressing changes during the process. After Mr. Fan was diagnosed in 2019, he has changed at least three drugs so far. Fortunately, in the past few years, a variety of new drugs have been approved for the market, and finally the doctor recommended that he use an oral treatment plan that takes once a week, which greatly reduces the tossing degree of his drug purchase.
Mr. Fan summed up according to his own experience, the treatment of multiple myeloma more and more drugs, the price is getting lower and lower, as long as you can adhere to long-term standardized treatment, one day multiple myeloma will become a chronic disease, patients can coexist with it for a long time, and eventually defeat it.
Ms. Liu's doctor will also give her science popularization, using an image metaphor: multiple myeloma cells are like leeks, cutting a stubble and a stubble, and all the doctor can do is to control it with drugs. Therefore, the patient's medication must not be interrupted, and must follow the doctor's instructions to standardize the use of drugs.
After more than two years of fighting multiple myeloma, Ms. Liu also summed up her own set of rules on the basis of medical advice. "Regular review, if there is a sign of recurrence, find it as soon as possible, follow the doctor's instructions as soon as possible to adjust the medication, and the treatment will be simpler," she said, "If it recurs in its entirety, it will be very tricky to cure and the degree of danger will increase." ”
At present, she has been able to basically rely on others, and it is no problem to cook and go out for a walk. Ms. Liu's greatest wish is to be able to take care of herself in life, not to increase the burden on her family and children, and to see the third generation, to help her children bring their grandchildren and enjoy the joy of heaven. Mr. Nie hopes that his optimistic story will encourage more patients to overcome the disease, reduce the chance of recurrence, and maintain good health.
Figure: After standardized treatment, Ms. Liu has gradually returned to normal life
With the continuous improvement of medical standards, I believe that their wishes will be realized. Every Year in March is also the International Myeloma Care Month, we also have the honor to interview these brave soldiers who love life and fight multiple myeloma, and also hope that more people can establish a scientific understanding of myeloma, do not be afraid, and actively standardize treatment.
Finally, through the video clip, let's take a look at the anti-cancer story of Ms. Liu, a patient with multiple myeloma.
Doctor reviews
Professor Sun Chunyan | Head of myeloma sub-specialty of Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology
Thanks to the continuous emergence of new drugs, the treatment of multiple myeloma has made great progress in recent years. In the past, when there were no new drugs, the survival period of the median was only two to three years; now this number has increased to six to eight years. After standard treatment, the overall effectiveness of multiple myeloma treatment can reach 80% to 90%, and it has entered the mode of chronic disease control. Especially like Ms. Liu, who is relatively young among patients, has good physical conditions, and the probability of effective treatment is very high.
And as drug development moves forward, it becomes more and more convenient to take medication. The main patients of multiple myeloma are the elderly group, it is very difficult to buy drugs during the epidemic, it is more difficult for the elderly to go out to buy drugs, fortunately, there are also oral treatment programs, which reduces a lot of burden on them.
It is hoped that all patients can standardize treatment, take medicine on time, and regularly review the disease, so that once the disease has recurrence and a small lesion appears, the doctor and the patient can cooperate to eliminate the lesion in the bud and strangle it in the cradle.
Professor Sun Chunyan
Head of myeloma sub-specialty of Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology
Sharing personal experience does not constitute a diagnosis and treatment recommendation, can not replace the doctor's individual judgment of a specific patient, if you need to go to a regular hospital.
Author: Zhou Xiaohei
-Produced by Fruit Shell Commercial Technology Communication Department-