Well, my training has not been going as well as I had hoped.  I know. I know.  But, to tell you the truth, I am a little worried about the distance and what it will do to my body. I am old.

I cycled the 30-mile loop around Scott on the weekend, which is beautiful and very, very flat. The countryside reminds me a bit of Holland with the water and flat fields–the end of which can only be seen because of the trees.  There was plenty of water because of the recent rain, but my view of the land was curtailed by the height of the corn, which was no longer green but brown and dried out.

The issue for me was the temperature, which had gone up to 97 degrees.  I have no idea how hot it truly felt had the humidity been taken into account, but it was pretty freakin’ hot.  Early mornings have never really been my forte, so by the time I woke up, said hello to my family, downed my coffee, and finally surfaced to sufficiently get the bike onto the car, it was eleven o’clock. Yes, I know. With another thirty or so minute drive to Scott, it was around 11:30 before I even got on my bike.

So, I have been in the south  now for over three years, and arguably I am a pretty smart guy, so it’s crucial to ask the question– especially as I am well aware of the old adage “mad dogs and English men go out in the midday sun”–  Why does this keep happening to me?

It was a 30-mile loop, and the first 20 were absolutely beautiful.  It was warm, but the slight breeze made it bearable.  Then with each mile, it got hotter and hotter.

“Yeah, I’m really enjoying this 110-degree weather!” said no one ever. I was becoming dehydrated and more and more tired. There was a total lack of shade, and with a total lack of hair to protect my head from the blaring rays, my bald head was becoming burned.  I began to feel worse and worse.  Basically, it sucked.

So, there are a few valuable lessons to learn here.

Number one:  Get up early, get on the road early, finish riding before your head turns into a baked potato, and keep well- hydrated. The ride is 100 miles, so get used to it!

Lesson number two:  The clothes you wear are important.  Don’t try something new on the day of the race.  Definitely wear a kit you have worn before and are comfortable in.  For me, the most important items are of the spandex/Lycra variety.   These come in a range of subtypes and have become increasingly popular, driven largely by the interesting social phenomenon known as “MAMILs” (pronounced mammals).  For those of you not familiar, a MAMIL is a middle-aged man in Lycra, who has decided that cycling is the new golf.  It has become a standard on weekends at the Big Dam Bridge to see a series of portly aging men of all shapes and sizes looking resplendent in the tightest garments you can imagine.  These brightly colored species whiz everywhere on their shiny new carbon bicycles screaming “on your left” at the top of their voices without any respect for the pedestrians they pass. They probably aren’t aware that the regulars are mildly ridiculing them as hapless wannabes.

What they also don’t know is that their so-called dapper duds were designed by a woman with a wicked sense of humor.  Tight-fitting bibs on pendulous beer bellies should never be seen. We can only be grateful that most do have the decency to wear a top of some sort, which covers up most of the offensiveness.

Despite them being jocular, the bibs do serve a real purpose – ask anyone who has ridden a bike without the padding in the tail end. Wearing well-designed bib shorts can go long way in terms preventing a number of difficulties, including saddle sores and other woes.    Another choice might be to add a little glide to your ride to reduce the friction and prevent chafing.

The thing is, the proper-fitting attire and accompanying gear can really make a difference, especially during a long ride.  So, while faintly ridiculous, go ahead and channel your inner Lycra-clad road warrior self and be proud. Stand tall, suck your gut in, and own your MAMILhood.

Cheers!

Aug. 4, 2017 | Patients of the UAMS Myeloma Center will soon be wrapped in additional care and comfort, thanks to the Subaru Loves to Care initiative launched last year by the vehicle manufacturer in partnership with the Leukemia & Lymphoma Society.

As part of the nationwide initiative, employees from the Subaru of Little Rock dealership and the Arkansas division of the Leukemia & Lymphoma Society arrived for a noon visit July 26 bearing boxes filled with nearly 100 blankets to share with patients receiving treatment in the Myeloma Center’s fourth-floor infusion clinic.

“This is a really important gift for us and we thank you all very much,” Gareth Morgan, M.D., Ph.D., director of the Myeloma Center, told those assembled for the presentation, including several patients and their families.

“With temperatures reaching nearly 100 degrees outside right now, I guess some may wonder why these patients are getting these blankets now,” Morgan said. “But if you’ve been in a hospital for any amount of time, you understand that it can get very cold in here,” he added with a chuckle.

Delivering the blankets to UAMS were Leigh Ann Brannon of the Leukemia & Lymphoma Society and Subaru of Little Rock’s Lucas Darius, Charles Clark and Cecil Turner, manager of marketing and sales. Turner said his own life had been touched by a loved one diagnosed with cancer.

More than 38,000 blankets will be delivered across the country to patients in their communities fighting cancer.

Some of the patients like Bennie Utley, of Cabot, have been battling the illness for years.

“I was diagnosed in 2005,” Utley said. “My urologist referred me here for another disease and my quality of life is really good. I am happy to have this place so close to us.”

Donald Robertson and his wife, Yolanda, began traveling from Baton Rouge, Louisiana, to Little Rock for his treatment after he was diagnosed three years ago.

“We wanted to come to the top place for stem-cell transplant,” said Yolanda.

This summer, visitors to 475 Subaru retailers nationwide were given the chance to share personalized messages of hope to patients in their local communities. Those participating also received a bracelet to help spread awareness of leukemia and lymphoma and the automaker’s goal to extend care and hope.

After distributing the blankets, the Leukemia & Lymphoma Society, which exists to find cures and ensure access to treatment for blood cancer patients, including those with myeloma, will feature online inspiring stories and photos of survivors and patients from across the nation.

The UAMS Myeloma Center is the world’s foremost research and treatment center for multiple myeloma, a cancer of the blood’s plasma cells. Visit cancer.uams.edu/myeloma.  Find us on Facebook, Twitter or YouTube.

The elevation is one of the harder aspects of taking on a long bike ride. Although you may think the state of Arkansas is flat because of the Mississippi Delta region that makes up the southeast portion of it, I’m here to tell you that is certainly not the case.   The Big Dam Bridge 100 cycling course has a total ascent of 4840 feet, with the worst headache coming right around mile 65, where there is this massive hill with an elevation that peaks at about 815 feet.

So, I know what you are ‘supposed’ to do when it comes to training to improve your climbing ability.  It’s all about the power-to-weight ratio.  In other words, to be in top climbing shape, you need to weigh roughly twice in pounds what your height is in inches.  So if you are, let’s say, 5’10 (70 inches) you should weigh in at a whopping 140lbs. Seeing as how I’m not going to be one of those Tour de France guys breezing through the mountains of the Pyrenees, singing “Ain’t No Mountain High Enough,” I’ll skip the lettuce-only diet and stick to what works—ice cream.

Another thing to do is to try and stay seated most of the way up.  It uses less energy than coming off of the saddle, and with 30 plus miles remaining, that is important.  Of course by mile 65, staying seated is difficult when that part of your body you desperately try to ignore occupies your entire existence… When you can no longer appreciate the sweet smell of sweat and burnt rubber on the beautiful path of victory because all you can think about is that bloody pain in your rear.

While staying hydrated is really important– especially during the Arkansas heat– taking in too many liquids will cause you to make multiple stops to answer the call of nature.

Managing your caloric intake is also crucial for a 100-mile ride, so it is important to keep eating along the way.  It will definitely help you feel a lot better at the end of the race.

As I was riding at about the 30^th mile, I started thinking about all the dangerous encounters one might face while cycling the trails in Arkansas.  From the snakes to the big trucks, the open road can be a hazardous place, especially if you aren’t in a car.  This is evident by the volume of carcasses spotted on the roads. I mostly see armadillos (like today), but there are also many other species out there.  There is roadkill everywhere!

Let’s not forget the mosquitoes… Oh, and the ever-present multitude of gnarly gnats that get in your eyes, up your nose, and in your mouth.  The gnat splats on my forehead are a real badge of honor.

Then, of course, there’s the fluctuation in weather, which I was lucky enough to encounter today.  It began with beautiful sunshine, and I didn’t have a care in the world. The next thing I know I was surrounded by mammoth dark clouds with grumblings of thunder in the distance. I thought to myself that this was not going to work out well.

And it didn’t. It was a complete disaster. I was prepared for the heat and dehydration, but what I got was thunder, lightning, and more water than I could imagine with the torrential downpour of rain. I guess you can never be too prepared.  If it looks sunny, you better pack a rain suit.

Cycling is awesome and truly invigorating.  It’s a quick way to get about, take in the fresh air, and appreciate the environment surrounding you.

But riding around enjoying the scenery does little to prepare you for the demands of an intense race.  At some level, I thought this “old man strength” phenomenon might kick it into gear for me.  You know what I’m talking about…like one of those burly old dudes, you see at the gym who somehow manages to defy gravity by bench-pressing  5 times his bodyweight like some sort of geriatric He-Man.   And why do they always wear these pants that clearly have been shrunk in the dryer?  I’m told these are real and not some sort of laundry mishap.  Skinny pants? No thanks.

Anyway, for me, ramping up slowly to build endurance through longer and longer rides are the most practical approach to taking on this challenge. Plus, it’s nice to have someone training alongside you for encouragement (and if you take a little spill).

So, off we go. Did I mention that ice cream is a crucial part of my training?

Cycling requires an intense amount of energy, and the body needs help to keep it at its optimal performance level.  If you don’t refuel, you will learn that it isn’t long before you encounter the dreaded “bonk.”  For you non-cycling enthusiasts, it means hitting the wall, r experiencing a complete loss of energy and your legs feel like cement.

Besides, I would rather do anything than train for hours without some sort of self-gratification. And the more miles you ride, the better the ice cream tastes. So, with this in mind, Sunday’s training involved a stop at the local ice cream shop in the downtown River Market district area.  It’s quite a fun place with good food, alcohol, and above all else, my favorite chocolate ice cream. The store windows also provide an opportunity to check yourself out—you know…taking a quick glance to see what you look like when you ride.

There’s my bike in the picture… and some bald guy who happens to be walking by. He was trying to check himself out in the window but turned away when he saw us taking photos.  Anyway, getting a dish of ice cream is a stroke of genius.

After the stop, we headed off again.  We traveled over into the North Little Rock side of the river. It is very pretty riding through the nature park which forms a major part of the Clinton library area.  It is a great place to hang out, relax, and look for birds and snappers.  You can see the river and the river trail as it leads into the downtown area. We took some great pictures.

So, I am pleased to say that today’s training went very well.  As they say, those who train (and eat ice cream) together remain together.

Multiple myeloma is a rare cancer, representing about 1.8% of all cancers combined, according to the National Cancer Institute. About 30,000 new cases are expected in the U.S. in 2017. It is more common in men than women, among individuals of African-American descent, and those aged 65 years and older. The SEER Cancer Statistics Review, a report of the most recent cancer incidence, mortality, su

Multiple myeloma is a rare cancer, representing about 1.8% of all cancers combined, according to the National Cancer Institute. About 30,000 new cases are expected in the U.S. in 2017. It is more common in men than women, among individuals of African-American descent, and those aged 65 years and older. The SEER Cancer Statistics Review, a report of the most recent cancer incidence, mortality, survival, prevalence, and lifetime risk statistics published annually by the Surveillance Research Program of the National Cancer Institute, notes that the five-year survival rate of myeloma is 49.6%.

It has been an exciting time at the Myeloma Center at the University of Arkansas for Medical Sciences (UAMS), in Little Rock, Arkansas, on all fronts, namely, embarking on research that could play an important role in the development of preventative and curative strategies for multiple myeloma in the future.

“We continue to see a large number of patients with multiple myeloma and other plasma cell disorders from across the United States and the world,” says Gareth Morgan, MD, a physician and director of the Myeloma Center. “Our research investigations have led to some exciting discoveries in the biology of myeloma based on the genetic variations within the human genome. With our colleagues in Europe, we have identified eight new genetic variations that could be linked to an increased risk of developing myeloma.”

UAMS is focused on developing a molecular classification of patient subgroups with distinct pathogenesis and clinical behavior. It partnered with Celgene and the Dana–Farber Cancer Institute in establishing a global collaboration called the Myeloma Genome Project.

“The goal of this project is to compile and analyze the largest set of genomic and clinical data to design a molecular classification system to improve the diagnosis, prognosis and treatment of myeloma,” Morgan says. “This initiative could really lead the way in developing targeted treatments for patients in the future.”

Morgan recently spoke with Managed Healthcare Executive (MHE) about other promising developments in the multiple myeloma field, as well as the challenges and ways to overcome them.

MHE: What are healthcare executives’ major challenges in the area of multiple myeloma?

MorganMorgan: Uncertainty about the future of healthcare policy and payer coverage is clearly one of the biggest challenges faced by leaders across the industry. We know that patients diagnosed with a complex cancer like myeloma fare better when they are treated by a specialist at an experienced facility like the UAMS Myeloma Center, when compared to oncologists in community-practice settings for whom myeloma may only represent a small portion of their patient population.  Unfortunately, some patients don’t have access to specialized myeloma programs because of insurance or other financial restrictions. This is something we see every day.

The personal and economic burden of a cancer diagnosis like myeloma really heightens the urgency for more research, but decreases in federal and state funding have made it more difficult.

MHE: How can these challenges be met or avoided?

Morgan: Maintaining the quality of clinical care and sustaining our research program are our highest priorities. We are not implementing cost reduction strategies but rather are discovering more effective ways to improve outcomes by addressing variations in practice and optimizing resources through a service-line approach. We are also expanding our collaborations with university and industry partners to develop new clinical trials to answer strategic questions related to high-risk disease. We are also working on improving the myeloma clinical guidelines through the International Myeloma Working Group.

MHE: What are promising developments in multiple myeloma?

Morgan: The increased understanding of the genetics and epigenetics involved in the initiation and development of myeloma cells has really powered the concept of precision medicine, such as the development of targeted therapies directed at specific mutations at the molecular level.

Immunotherapy represents another promising treatment approach for patients.  Addressing relapsed disease via resistant clones has led to the development of new immune-based strategies, some which are already approved and providing results and others which are in development.

An exciting advancement on the horizon is the development of a peripheral blood biopsy as an alternative to bone marrow aspirate and biopsy, which not only would be more comfortable and convenient for patients, but may also offer a more comprehensive profile of myeloma cells, which could be of particular use in the earlier stages of the disease, such as in pMonoclonal gammopathy of undetermined significance]  and smoldering myeloma.

So, first I would like to say that bicycling is a great joy in my life, but I find that I really cannot tell you that.  I am aging, and it is killing my body.  Nonetheless, let’s get this blog thing going.

Besides being a middle-aged Welsh myeloma doctor from London, now living for almost three years in Little Rock (please no overused sheep jokes), I have been cycling for about five years.  I used to run, but now I am old and arthritic.  And I like to wear spandex.

So, this year I’ve decided to ride in the Big Dam Bridge 100 in September—the full 100 miles.  It will be good for me. The training is challenging, but finishing the ride is well worth it.  It’s similar to what patients go through when they undergo chemotherapy or other treatment.  It can be difficult, but having a good team, good equipment, and a good attitude makes all the difference.

We’ve formed a team here at the Myeloma Center, and Faith (Dr. Davies), Brian, and others have joined me in training for the 100 miles.   We hope that by riding as a team for our patients, we can increase awareness about myeloma in the community and raise funding to support our research at the Myeloma Center.

It should be quite awesome actually.  Seriously.  So whether you would like to join me this year on the 100-mile ride, or just want to check out what all the bike hype is about, you should sign up and plan on joining us.  There is a 10-mile route for the beginners, and there are other routes ranging up to the 100-mile motherload that I like to think of as my Tour de France. Well, that’s it for now. I’m hungry and plan to have curry.

Cheers!
Gareth Morgan, MD.