Archive for the ‘Terry Hollenbeck M.D.’ Category


I am in remission of my multiple myeloma cancer. The three months of chemotherapy last fall and winter did a great job in knocking out most of those cancerous plasma cells which were taking over my body. The stem-cell transplant I was originally to have following chemotherapy has been canceled. I will have my blood tested regularly to monitor my remission. My thanks to Dr. Michael Wu and his wonderful caring staff at the Palo Alto Medical Foundation oncology department who did a superb job treating my disease.

I discovered that one doesn’t necessarily have to leave Santa Cruz for state-of-the-art cancer care that I found right here through my group at PAMF. I sure wasn’t used to being — nor particularly enjoyed — being on the patient side of the doctor/patient relationship. It was a humbling experience and has taught me more about patients and patience along my journey.

Unfortunately, I am suffering from a fairly severe neuropathy of my feet from the chemo drugs, and this is currently adversely affecting my ability to walk normally. I do, however, feel it’s a small price to pay for my successful cancer treatment. I’m told the neuropathy should improve with time. I’ll try to be patient, (not one of my virtues however).

Another little complication I had in the past month, most likely unrelated to my cancer or treatment, is a condition of my heart called constrictive pericarditis. This occurs when the sac of tissue surrounding the heart (the percardium) becomes inflamed and tightens in on the heart, causing the heart to pump less efficiently.

This threw me into mild heart failure with significant shortness of breath, swelling of lower extremities and general fatigue. Dr. Neil Sawheny, one of my cardiologist partners at PAMF, is treating me for this unexpected complication and I seem to be responding well and improving day by day.

In general , my overall well-being is improving significantly. I feel as though my life as I once knew it is being slowly restored. Once my neuropathy shows signs of improvement, I hope to return to work at least half-time.

I’ll give myself a break to work a bit less since I’ve now been practicing medicine for the past 40 years, 27 years in urgent care Scotts Valley. I love my staff, my patients, many of whom I’ve come to know quite well. Most of all, I love the satisfaction I receive in helping make people feel better and in maintaining their good health.

My thanks to all of you who have mailed get-well cards or sent email messages for my recovery. I am a strong believer in the power of prayer and I know your prayers for me have been heard.

My personal lesson from my cancer experience is this: If you have any health symptoms that seem unusual to you or are lasting longer than you think they should, see your doctor for a work up. If everything checks out OK and your symptoms soon improve, then be thankful.

If something serious like cancer is found, the sooner it’s treated the better the outcome. This a proven fact. Also, for those many of you who are healthy, give thanks every morning that you can begin a new day.

My best wishes to you for long healthy lives.

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hollenbeckAs many of you know, I was diagnosed this past October with a cancer called multiple myeloma. This is a cancer of the plasma cells which are found in the blood and produce antibodies for our immune system. These malignant cells multiply rapidly and can cause damage throughout the body, especially affecting bones and kidneys and ultimately lead to death within two years if left untreated.


Myeloma’s effect on bone causes extreme osteoporosis (thinning of bones), which brought about my first symptom of back pain. This was due to several of the vertebral bones of my spine collapsing, which is referred to as compression fractures. Blood tests were done to find out why an otherwise healthy guy like myself would have these fractures. The specific test for myeloma was positive. This was shocking news to me as I immediately saw my life passing in front of my eyes. I was reassured, however, by being told by my oncologist that there is great new treatment for myeloma that can bring about long remissions.

The next step was a bone marrow biopsy to determine the severity of the disease. This procedure involved numbing the skin over the back of my pelvic bone and inserting a needle into the bone marrow to obtain a specimen for more detailed evaluation.

I then began a two month course of chemotherapy at our oncology infusion center here in Santa Cruz. I received three drugs. One was given as a shot (not by IV) and the other two were in pill form. One of the pills costs $700 per pill! Not an uncommon price for the new generation cancer drugs. My particular course of chemotherapy did not cause me to lose my hair, make me sick to my stomach, or any other of the common chemotherapy side effects. I was feeling pretty smug about how I was sailing through the therapy when finally a side effect caught up with me. I developed numbness of my feet and my hands, a condition called peripheral neuropathy. It is causing me some difficulty walking and maintaining my balance. I am told this condition should improve with time, but there is no guarantee that it will go away completely.

Regarding the ongoing back pain from my compression fractures, the day after Christmas, I had a procedure called kyphoplasty, done by a spine surgeon at University of California, San Francisco. This procedure involved my receiving a general anesthesia followed by the surgeon inserting a large needle into each of 4 compressed vertebral bones. Through the needle a small balloon is blown up to help open up the collapsed bone. The balloon is then removed and a rapid drying cement like substance is injected into the boney space. This helps to restore some integrity to the compressed bone and keeps it from collapsing further. It also usually improves the associated back pain, which fortunately proved to be true for me.

So I am now with much less back pain, but with numb feet, weak legs and some unsteadiness. I am tentatively scheduled for a stem cell transplant which will take place at UCSF in mid-February. At that time I will be hospitalized for an estimated three weeks, then allowed to return home, and will be on house confinement for another four weeks. After that it should take a few months to return to normal activities.

So, it is at this time that I will take a short leave of absence from writing my column, to allow me to focus in on the upcoming stem cell transplant and recovery. I will resume my writing after all is said and done and describe this experience.

Thanks for the prayers, cards, emails and general well wishes I have received from so many of you. It makes this all somewhat easier for me, as well as for my wonderfully supportive wife Beth and my dear daughter Emma.

I’ll be back!

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As we prepare to begin a new year, I’d like to share with you some highlights from my columns this past year.

Upper respiratory infections:These infections which cause coughs, sore throats and congestion, are almost always caused by a virus infection and shouldn’t be treated with antibiotics. If symptoms continue to worsen, especially accompanied by a fever, see your doctor for evaluation and treatment.

Hepatitis C:Baby boomers (those born between 1945 and 1965), should be tested for hepatitis C as more than two million Americans currently are infected with this disease and many who are, are unaware of it.

Advanced directives:Sometimes referred to as “living wills,” advanced directives direct physicians as to your wishes for medical treatment if you were to be incapacitated and unable to make decisions on your own. Talk with your doctor about this important document.

Swallowing pills:If you have trouble swallowing them whole, most pills, capsules, or liquid medications, can be crushed and mixed in most any type of food. Check with your pharmacist to ensure that your particular pill or capsule can be mixed with food.

Hearing loss:If you are having problems with your hearing, make an appointment with a qualified audiologist and have a routine hearing test. Technological advances have made hearing aids an excellent option to restore hearing.

Hydration:To keep your body healthy, drink a glass of water or other low- or non-calorie beverage with each meal and between each meal, and drink water before, during, and after exercise.

Constipation:First try life style changes such as adequate liquid intake, and regular exercise. Maintain a high fiber diet to include beans, whole grains, fresh fruits and vegetables, and less dairy, red meat and processed foods.

Childhood immunizations:Immunizations are safe. Many well-controlled scientific studies have all concluded that there is no scientific or statistical relationship between immunizations and autism.

Vision disease:See your doctor immediately if you have any obvious visual change. People between the ages of 18 and 50 should have routine eye exams every two years and every year after the age of 50. Children need routine eye exams as well. Ask your child’s doctor about the frequency.

Hair loss:Losing some 50 to 100 hairs a day is considered normal. If you are experiencing what you consider to be hair loss of more than or sooner than you expect, talk to your doctor or dermatologist. Do this before spending a lot hard earned money on worthless treatments which are so frequently advertised to the public.

Nonprescription pain medication:You may choose from Tylenol, Advil, Aleve, or common aspirin to relieve most simple pain. Taken in the recommended dosage, Tylenol, which is effective and has less potential side effects, would be my first choice.

Generic drugs:With only a very few exceptions, generic drugs are equal in almost all aspects to the equivalent brand name drug and are much less expensive.

Diverticulitis:If you have worsening pain in the left lower abdomen, or no improvement of such pain for a few days, seek medical help immediately.

Have a very happy and healthy New Year!

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multiple, myeloma, cancer

I would like to begin this week’s article with a deeply sincere appreciation for the outpouring of emails, cards, well wishes and words of encouragement from my readers, patients, friends, family and even strangers. This support will go a long way in getting me through my recent diagnosis of multiple myeloma. I’ve survived my first two weeks of chemotherapy and feel fine, except for the persistent back pain.

Although described as being somewhat uncommon, I’m aware of a number of people who have had multiple myeloma and many more who are acquainted with or related to someone with the disease. The good news is that most of them are doing well. I like to hear that.

So what is multiple myeloma?  It is a cancer that causes an over production of plasma cells — a type of white blood cell found in the bone marrow. Plasma cells function to produce antibodies which are necessary for our immune system to fight infections. In multiple myeloma, the growth of the cancerous cells causes them to produce an over-accumulation of a certain protein called immunoglobulin that travels throughout the body and can cause damage to various organs.

The other problem, as in my case, is that the plasma cells can enter normal healthy bone causing osteoporosis as well as causing local areas of bone weakness leading to bone fractures, such as I have in my spine. I also have the typical anemia because the plasma cells crowd out the red blood cells in the marrow.

The cause of multiple myeloma remains a mystery, however there are some associated risk factors such as:

– Being over age 65.

– Being a male.

– Being African-American.

– Having a family member with multiple myeloma.

Early stages of multiple myeloma may cause no symptoms. However, as the disease progresses, plasma cells accumulate in the bones and other tissues causing these symptoms:

– Unexplainable persistent pain in any location of the body especially the back.

– Extreme weakness and fatigue.

– Unintended weight loss.

– Recurring infections.

After seeing your doctor for any of these symptoms, you will have some blood tests done and if there is some indication that you may have multiple myeloma you will be referred to a doctor specializing in blood and cancer diseases. Further testing can prove or disprove whether or not one has multiple myeloma.

Therapeutic options include the one I just began, which is undergoing up to four months of chemotherapy followed by a stem cell transplant which I will explain in more detail as I get further along with my treatment.

What I have learned from my experience is that it is important to recognize early symptoms and see your doctor about your concerns. As with any cancer, the sooner it is detected and treated the better the chance of survival. If you or a loved one have any of the above-mentioned risk factors and unexplainable symptoms, see your doctor.

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For every article I write, I start research on my subject of choice and find I’m always learning something new, or I find the research to be very interesting. This week I’ve been forced to study up on subject that I didn’t know much about, but only because it was something I was just diagnosed with: multiple myeloma. This is a cancer of the plasma cells which are growing in my bone marrow.

Plasma cells function to produce antibodies to fight infections. My disease is producing an overabundance of plasma cells which left untreated can enter and weaken bones, cause anemia, and most seriously can destroy the kidneys. As I received the news, I found myself on the other side of the doctor patient conversation and felt the pang of hearing I have something that is life-threatening if not treated.

My journey with this disease began several months ago when, after recovering from the hip injury secondary to my bicycle accident, I developed pain in my lower back which was at first attributed to the result of the bike accident. When the pain continued worsening, I saw one of our back specialists who ordered an X-ray followed by an MRI of my spine. These studies showed that I had three compression fractures of my vertebral bones, which was quite unusual and was unlikely to have been caused by the bicycle accident.

I then underwent another X-ray study of my bones called a Dexa Scan which showed that I have osteoporosis, which is a thinning of the bones. Soon to follow was a battery of blood tests to find the cause of osteoporosis, one of which showed an abnormality which could be caused by multiple myeloma. Next step was to get a bone marrow sample where, after numbing the skin, a large needle is inserted into the bone marrow in the back of my hip bone and a sample is obtained. This specimen was then sent to a special laboratory in Southern California.

I had a PET scan, which is a modified CAT scan, to look at all my bones to determine the extent of my myeloma. In the end, it was determined that my PET scan showed spots on my bones and the bone marrow study showed fairly advanced myeloma disease.

The final decision is that I will begin chemotherapy this month, lasting at least four months. Then I hope to get a stem cell transplant at the University of California San Francisco where I will have to stay for another four months.

I’m told that my disease is treatable and can add years to my life if I do what is being planned for me. I am currently on an indefinite leave of absence from my work, which I will thoroughly miss.

So here I am, the doctor now the patient. Have to admit, I like the doctor role better. But this is what life has dealt me and I envision myself on a path toward healing. The journey will be rough and dangerous at times, but I will do what I can to restore my health. They say doctors don’t make good patients, I hope to prove that wrong.

I do plan to continue writing my articles as long as I am able to do so. In fact, I look forward to sharing my journey with you as events unfold.

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November 11 is Veterans Day. Although I never had to serve in the military, I honor those who did. I especially have the highest regard for those who actually saw combat and put their lives on the line for me and my country. To you ladies and gentlemen, I give my deepest thanks.

Today I’d like to honor my favorite veteran, my late father, Dr. Stanley Hollenbeck. Dad was born in 1911 in Milwaukee, Wis., where I was also born and raised. He graduated from Marquette University School of Medicine in 1936 and began a private practice. Around that same time, he joined the Wisconsin National Guard.

With the onset of World War II, his regiment became part of the Army’s 32nd Infantry Division which was sent to Australia in May 1942. Dad left behind his new medical practice, his wife and his newborn son, my brother Stan Jr. I can’t imagine how Dad felt about leaving his comfortable life behind, especially not knowing what he would be facing, as he would be thrust into the escalating war with Japan in the South Pacific.

Dad was the commanding officer of the 14th Portable Surgical Hospital, one of the army’s first Mobile Army Surgical Hospital units, which were later popularized by Alan Alda in the TV hit series “M.A.S.H.” Dad and his crew were sent to the north coast of New Guinea near a small village called Buna, where the enemy was deeply entrenched. His unit’s bulky, hot, humid hospital tent was set up less than 1,000 yards from the front line where hand-to-hand combat was taking place.

Health conditions for the troops were among the worst in the world. The mosquitoes and flies were horrific. Almost all soldiers, including Dad, suffered bouts of malaria. Everyone had recurrent dysentery. There were also scrub typhus, dengue fever, hookworm, yaws and countless cases of “fever of unknown origin.” Troops suffered from depression and severe battle fatigue caused by the relentless hot, humid, rainy weather, the jungle and inadequate food. For every two men who were battle casualties, five were out of action from fever.

Dad and his crew often operated day and night on the young wounded soldiers. This took place in a large canvas tent by lantern light. Temperatures inside the tent could reach up to 130 degrees. All of this was done under frequent machine gun strafing and bombing by enemy fighter planes, as well as the constant threat of being overrun by enemy troops.

Dad kept a daily diary of his life in New Guinea, which was later published by his Veterans of Foreign Wars group in Milwaukee. I would like to share an excerpt from that diary. On Nov. 16, 1942, a five-boat convoy bringing desperately needed ammunition, food and medical supplies to the troops was attacked by enemy aircraft, setting all the vessels ablaze. Dad and his crew witnessed the attack from the shore.

In his diary, he later wrote: “I grabbed my medical kit, forded the river and started up the beach. I could see the boats burning fiercely as night began to fall. I was frightened to death not knowing exactly where the enemy troops would be as I walked along the jungle’s edge. I continued up the beach, checked on survivors and rendered first aid. I had the more seriously injured sent back to our hospital tent. I hurried back to get ready to operate on the wounded. We operated all night long on the men, mostly with abdominal wounds, sewing up the bullet holes in their intestines, besides treating other serious wounds. We finally finished, getting to bed at 4:30 a.m.”

From October 1942 through February 1943, Dad remained just behind the front line, operating and treating wounds on countless injured soldiers. Lives were lost, but many more were saved due to the efforts of Dad and his crew. In February 1943, the 14th Portable Surgical Hospital was awarded the Distinguished Unit of Citation, and several individual members of the unit, including my father, received the Silver Star medal for gallantry in action. He also received the rank of lieutenant colonel.

Dad told me that he and his fellow soldiers were willing to put their lives on the line, believing that a victory would end all wars and that their children would never have to do the same. Unfortunately, such a dream was not to come true. Sons and daughters are still sent to battle.

Here’s to you, Dad, of whom I am so very proud, and to all the other brave veterans living and dead. I salute you and I honor you.

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