I have invented a new dish called “curcustrone.” 😉 Background of the “invention”: the other day I made a huge pot of minestrone, a very rich Italian vegetable soup with beans. Yummy, if I do say so myself. I use all sorts of vegetables, a few herbs and two kinds of beans (Italian cannellini and bortolotti).

Stefano and I like our minestrone mixed up in a blender because the tastes become more homogeneous, which explains why you cannot see any bits of carrot or potatoes or rosemary or spinach or sage floating on the top (photo on the bottom right). So what does minestrone have to do with curcustrone? Well, today, since I had to have a late lunch and didn’t have enough time to make my curculate (chocolate and curcumin) mixture, plus, to be honest, I was starving, I went ahead and mixed my curcumin and quercetin powders in a bit of olive oil (top left photo, before mixing), heated up a bowl of minestrone, and mixed it all together (bottom photo, showing the minestrone on top of the curcumin oil and beginning to turn orange). This time, I did remember to take a few photos. Not the best photos I have ever taken, but they give an idea of what this concoction looked like. I admit that it tasted a bit odd, but it was still very palatable, and it was a nice change from curculate. A good solution (I hope!) for when I don’t have much time to spare.

Well, I have been a bit lazy this long holiday weekend. Lazy in terms of doing my research and answering e-mails (sorry!), mainly. But today was such a glorious day that Stefano and I went on a nice walk up through the hills behind our street. The last time we walked up there was when it snowed in Florence…two years ago! Shameful. At any rate, we finally had to turn back and go home because of the icy slippery roads. I confess that I am one of those odd creatures that adores cold weather and simply goes bonkers over snow…

We live in a very nice neighbourhood of row houses built in the late 1920s and surrounded by hills, cypresses and trees of all sorts, olive groves and fields. It feels as though we live in the country, but we are just a few minutes away from a main busline that takes us downtown in about 20 minutes. It’s a wonderful area. Here are a couple of the photos I took earlier today. The top one shows a view of an olive grove and, if you look very closely, you can make out a bit of Florence in the background. The second photo is a view of the road we…climbed. Here we were about halfway up, or halfway down, depending on which way your back was turned. 😉

Blog reader notes. For my UK readers: please reply here or to me privately if you have an answer to Dora’s question (see my Curcumin Curcumin Curcumin! post). Thank you! And Val, I think he recommends curcumin with bioperine capsules, but am not 100% sure. I will ask him and let you know.

My MMA list friend left for Sorrento this morning. From there, she will visit Naples, the Amalfi Coast and Pompeii. She will be back in Florence on Tuesday. She planned this short trip, I think, in order to leave Stefano and yours truly alone for the long weekend. Very thoughtful of her! We don’t have anything romantic planned YET, but we will definitely do SOMETHING! After all, it is not too hard to be romantic in Tuscany…!

Back to my post title. I finally had the time to read, carefully, the comments on my October 28th post. WOW! Thank you, everyone. The comments were so out of the ordinary that I decided to write an entire post about them. Proceeding in order, more or less:

Eileen. Interesting abstract on the transfollicular delivery system, thank you. Well, well. Food for thought. Yes, the problem is how to avoid looking like a circus clown. Some time ago, I tried dabbing curcumin on my rosacea, which made me look as though someone had thrown bright orange paint in my face (the Sabinsa curcumin has an orange hue). This effect lasted for a few days, no matter how much I scrubbed my face. So I gave up on that plan, even though my rosacea did improve somewhat.

A perhaps (perhaps not!) related matter is that I have noticed that my tongue turns bright orange after I drink my curcumin powder mixture. I feel certain that my tongue delivers at least some curcumin to my malignant cells (even if that is not the case, I will continue to believe it until someone tells me otherwise). Not that I am an expert of Ayurveda or Chinese traditional medicine, but I do know that the tongue is very important and, after all, many conventional and alternative remedies have to be dissolved on or under the tongue. Ok, that’s beyond the point, here.

JHope’s comment: I have no idea! Anyone else?

Snezhi’s suggestion that we could make our own nasal sprays is also very interesting. I confess I do not have the know-how, but I would have no problem spraying curcumin up my nose, and I say this seriously, even though it might sound facetious. And hey, how about the nose hair follicles (see Eileen’s comment)? There you go, more food for thought…

Don: thirty-four GRAMS of curcumin??? At times I have gone up to almost 10 grams. Never beyond that. I cannot imagine taking more than 12, which is the most that, as far as I know, has been tested in Phase I clinical trials on healthy subjects. Perhaps there is more recent info on that, though. One word of caution: we do not know the long-term effects of such high doses (as the lab rats in Eileen’s household are taking). If I were on such a high dose, I would have all sorts of tests run every couple of months, perhaps even once a month, if possible. Speaking of taking massive amounts of curcumin, please read Wally’s brilliant comment carefully. If we can manage to make curcumin more bioavailable, we don’t have to take huge doses. Makes a lot of sense to me.

The matter of doses brings me to my friend Ana’s comment. She has just begun taking curcumin (e vai!!! 🙂 ), and has decided to take it in one large dose instead of two or three. Well, until quite recently, that’s precisely how I took it, whether it was powder mixed with a fat or curcumin with bioperine capsules. My counts remained stable and even decreased. So I say, whatever works for you, your markers and your daily routine…go for it!

Speaking of Ana, she and I have already discussed the idea of offering ourselves as lab rats to a doctor here in Tuscany who is doing a lot of research on curcumin, which he is using (successfully) with his prostate cancer patients. I haven’t talked about it here because I don’t know if it’s even feasible. But it’s well worth a try, perhaps two. I am going to get in touch with this doctor soon, perhaps even this weekend, to ask if he has access to a laboratory, and, if so, if he would be willing to set up a tiny trial testing Ana and me as well as our willing husbands (two healthy subjects). I may be able to get another Florentine friend with MGUS involved, too. I can provide the necessary curcumin powder or capsules, since I have plenty of both. My idea is that we could ingest different amounts of curcumin in different ways and at different times of the day, and then have our blood tested, obviously at different intervals etc. I will also approach my haematologist in Florence about this. Fingers crossed.

Wally is so right: we need this data. Soon. Now.

I haven’t had time to do any blogging in the past few days. No time for any research, no time to answer e-mails (for which I apologize!) or blog comments, etc. My to-do list is getting longer and longer. YIKES! I have simply been ignoring it. 😉 I have been busy, busy, busy, but away from my computer. I have spent a lot of time with my MMA list friend (fun!) as well as preparing my classes and teaching.

Tomorrow is a big Catholic holiday, called Ognissanti in Italian (All Saints’ Day in English, I think), and then we have a long holiday weekend, which I plan to spend with Stefano and also doing some research…finally! In the meantime, since today I again have no time to write a serious post, I just wanted to wish everyone a Happy Halloween! (P.S. The kitty in the photo is REAL: it’s my five-month-old Peekaboo! And no, even though it’s hard to believe, I didn’t put her there, I just set up my Halloween puppets, showed her how interesting that broomstick was, and she sat right behind ’em…my perfect photogenic model! Of course, a split second after I took this photo, she started chewing on the broomstick…) 🙂

Today I would like to continue quoting a message sent to me by one of my blog readers (the same who is quoted in my October 19th post) because I think it is tremendously important to understand what happens to curcumin once we swallow it. Not a simple matter, but my blog reader (thank you!!!) makes the process seem simple by using simple terms. Here goes:

The starting point to understanding the central issue of low bioavailability is to realize that curcumin is insoluble in water at pH of 7 and below. Therefore, in the stomach, where the curcumin first encounters body fluids, it remains insoluble because the stomach fluids are acidic. Once the stomach contents enter the small intestine they are changed to alkaline pH by the bile and other digestive fluids that are injected there. Curcumin is soluble in alkaline aqueous solutions at a pH of 7.4 and above and would dissolve in the small intestine. Then the curcumin molecules that are present only when a solution exists can enter the capillaries of the hepatic venous system that serves the stomach and the large and small intestines. Prior to solution, curcumin exists as small crystals or clumps of crystals that cannot pass through the tiny pores in the capillary walls–only molecules of curcumin can–thus the importance of having the curcumin in solution. However, it is found that in the stomach the curcumin is rapidly conjugated to curcumin glucoronide and curcumin sulfate, neither of which show any biological activity with the cells, as does curcumin. As a result, a considerably smaller part of the total ingested curcumin enters the small intestine, ready to be dissolved there. But some does dissolve and gets through the venous capillaries and then proceeds through the hepatic portal vein directly to the liver, where it undergoes “first pass metabolism” wherein more of the curcumin is converted to biologically inactive metabolites. All these hurdles must be surmounted before the curcumin gets a chance to circulate to the rest of the body to organs that might use it beneficially. The end result is that the measurable level of curcumin in the blood serum peaks very soon after a small two mg dose is given and only reaches a very low peak concentration.

Now consider the implications of these results for a person who takes that two gram dose of plain curcumin twice a day, approximately ten hours apart. Within the first hour after dosing, he sees a slight rise in his serum curcumin concentration, which blip then disappears within three hours, leaving nothing to supply to the tissues for the next seven hours. Then the same blip occurs after the second dose is taken, and some curcumin level exists for another three hours. So for about six hours total time there is some curcumin getting to the tissues and nothing for the other eighteen hours of the day. When developing a dosing amount and frequency for a medicine it is the objective to obtain an overlap between dose concentration peaks, so that there is drug available to the tissues for the entire 24 hours, even though the concentration changes as the drug is metabolized and excreted. It will be at the highest concentration shortly after taking a dose and will be at its lowest concentration shortly before taking the next dose. Two grams per day of plain curcumin simply will not give that desired overlap, and even curcumin with Bioperine will not do it either, because it also disappears within five hours. Only a much larger dose of curcumin taken together with Bioperine (or other means of enhancing bioavailability) is likely to achieve a continuous level of curcumin in the serum, though with peaks and valleys.

I hadn’t thought of the implications of curcumin crystals versus molecules before reading this message. A few things began to click in my brain. As I recall, my friend Don (see my October 25th post) takes curcumin at least three times a day. I try to take it twice a day, except on the days when I teach when it is difficult for me to do so. On those days, I usually take it in one big dose, all eight grams of it, when I get home in the afternoon. Now I realize that is probably NOT a good idea, and I will make some changes in my schedule so I always have a morning dose, too. The idea of keeping, or trying to keep, curcumin in the serum with overlapping doses makes total sense to me. After all, when we have a horrendous headache, don’t we take Tylenol or whatnot every four to six hours?

I was sort of dared to post my fuzzy puffin dot photos, so here goes! Enjoy! 😉

My MMA list friend is back from Venice, where she also experienced the thrill of high tide in St. Mark’s Square yesterday. Not much fun, but she was a good sport about it. She also returned with a cold and a cough, poor dear. Unfortunately, it rained during most of her stay. Bummer. Apart from those two things, though, she loved (how could she NOT???) and was overwhelmed by Venice. She told me that at one point she ran into a tourist who told her that she would be in Venice for just five hours and then would be leaving for another city on her tour group’s itinerary. I was appalled. Why bother going to Venice if you only have five hours? Just to be able to say: been there, done that? Well, five hours is better than nothing at all, I suppose…

Isn’t it just THE BEST to read great news first thing in the morning while you are sipping your cappuccino (or whatnot)? That is what happened to me today. I had a message from my friend Don waiting in my e-mail box, telling me to rush to his blog and check out his news. Well, well, it turns out that his most recent tests are very good if not excellent!, see: http://myelomahope.blogspot.com/2007/10/excellent-test-results.html Congratulations, Don! I will drink a sip or two of red wine in your honour this evening at dinner! 🙂

I have something else to celebrate. Yesterday morning my parents landed safe and sound in Boston. I am not celebrating their departure from Florence, of course, since it will be some time before I see them again (I hope, not TOO long!), but I do celebrate their safe arrival back home!

This has nothing to do with celebrations, but I wanted to mention that I tried a slightly different method of taking curcumin this morning: as usual, I dissolved four grams of curcumin powder in a bit of melted butter, then added melted dark chocolate. No milk, no cream. Well, the flavour of course was more intense compared to the milk drink, and the consistency was that of a rather liquid pudding, the kind that cooks might consider to be a failure 😉 , but it was certainly palatable. I forgot to take a photo.

Speaking of photos, yesterday I went to a friend’s website (a professional photographer) where I practically drooled over all his amazing photos of puffins. In response to my glowing fan letter, he suggested that Stefano and I go to Skokholm, a small island nature reserve off the south-west coast of Pembrokeshire, Wales. He also suggested a couple of other places. Last night, Stefano and I talked briefly about going to the UK for a week this summer, early summer, which is the best time of year to view puffins. This summer!?! That would be one of my dreams come true. You see, I am puffin-mad. Absolutely, completely mad! (No idea why, really, except I think these little birds are the funniest creatures I have ever clapped my eyes on.) Stefano is almost as obsessed as I am. Two years ago, we spent part of our U.S. summer holiday in Maine mainly to see puffins (Eastern Egg Rock, and off the coast of Acadia), but we arrived late in the breeding season, and most of these fantastic birds had left for the Atlantic. We managed to “see” a few, but they were nowhere near our tour boat so all that our photos show (when completely enlarged) are tiny fuzzy dots with an itsy bitsy dash of orange (the beak!)…very disappointing. Too embarassing to upload those photos here! 😉 I told Stefano back then that I wanted to travel to Wales to see one of the puffin colonies there. So 2008 may turn out to be our puffin year. Yes!

After days of rain and gloom, it’s finally what I consider to be a perfect fall day in Florence (earlier this afternoon I took the above photo, which shows part of the view we have from an upstairs window): a bit sunny, a bit cloudy, a bit windy, a bit chilly. Earlier this morning I went to the greengrocer’s to buy some salad, broccoli and fruit, and admired the leaves turning red and yellow. Not as spectacular as the New England fall (I was born in Massachusetts, and spent several years there, off and on), but pretty enough for me. Yes, it’s a very good day. For many reasons 🙂

I have an exciting announcement for all curcumin-takers with MGUS, SMM or MM! Please go to the Beating-Myeloma website (http://beating-myeloma.org/) and fill out the form for the Curcumin Patient Study! (See my September 7th post for a bit more information on this informal patient study).

Once you reach the B-M homepage, you will find the CPS listed under Patient Studies, on the left-hand side of your screen. Click on that link, and follow the directions. It’s easy. Only we have access to our data, so we can add updates whenever we get new test results and so on.

For some reason, today I had to scroll down the page to view the list of those (eight of us curcumin-takers) who have already filled in the form. So if you see a blank page, just scroll!

Anyway, in order to participate in the CPS, you must be a B-M member. If you are not, please sign up first (it’s free). As a member, you can also sign up for the forum/listserv, where discussions range from alternative to conventional and complementary myeloma treatments. It’s a very very very friendly group of myeloma patients (all stages) and MM patient caregivers, so I urge you to join.

If you are not a myeloma patient or are merely curious about curcumin and wish to view the study results, please click on this link: http://beating-myeloma.org/patient-study-results/

As David (the founder and owner of the B-M website) wrote in a post to the MMA listserv yesterday, this is not a rigorous trial but a collection or snapshot of mmers who take curcumin often along with conventional therapies like thal/dex or velcade. Experiences range from MGUS diagnosis changing to smoldering and IgG diagnosis in complete remission experiencing improving numbers…

While this is not a formal myeloma clinical trial, if enough of us participate we may gain some interesting and potentially important information about curcumin. So, whether your experience with curcumin has been positive or negative, please fill out the form. The more, the merrier!

My MMA list friend left yesterday morning for Venice. She will be back in Florence on Thursday. I would have loved to have accompanied her since I haven’t been to Venice in years, but I am teaching this week, oh well. Anyway, she is a truly wonderful person, and I feel as though we have known each other for decades instead of just a few days. Her visit has turned out to be a complete joy and has also been an eye-opener in many ways. I should mention that she is a professional therapist, and a very good one at that!, and perhaps that is why I find myself telling her things that even my closest friends don’t know. How does THAT happen??? Oh, and the funny thing is, she frequently doesn’t even have to ask me any questions. Words just start pouring out of my mouth. That’s never happened to me.

Today I want to write about one of those eye-opening discussions: feelings. Feelings, she said, are so rarely discussed on the myeloma listservs. I had never really considered that aspect of the myeloma puzzle. But she’s right: listserv members discuss treatments and symptoms and pain and so on, so why do we not discuss feelings on more than an occasional basis? The simple answer is, because it’s hard.

After giving the matter some thought, I have come to recognize that, when I do research, it is as though I am doing this for SOMEONE ELSE, not for me. I am not the myeloma patient when I don my researcher outfit. I become detached. Does this make any sense?

Perhaps my friend is right. Perhaps I keep my mind busy doing research so that I won’t have to deal with any feelings about myeloma. Even my blog, now that I think about it, may just be another way to avoid feeling. In my daily life I rarely think about myeloma, even when I take my curcumin twice a day. Sure, I visualize the malignant cells, but I probably don’t make the connection: those cells are PART OF ME. In fact, when I visualize them, they are outside my body. They have always been big slow hairy (no idea why I think of them as hairy!) stupid monsters that I slash and kill with my sword. Outside my body

This is a tough subject, and I am certainly not equipped to go into much, if any, depth, but it is also an interesting and perhaps very important one. My friend has given me lots of food for thought. At one point, she asked me if I had ever felt angry or if I ever feel angry, obviously in connection with myeloma. Angry? No, I answered immediately. How about sad, she asked? No, not at all. And fear? Well, yes, sometimes I do get scared, I admitted. Well, so what do you FEEL?, she insisted. I answered: I feel determined. But determination isn’t a feeling, she pointed out. It isn’t? Darn it, she is right. Merriam Webster defines determination as the firm or fixed intention to achieve a desired end. There is no emotion attached to determination (or is there?). So am I not allowing myself to have emotions about myeloma? But I DO have emotions, my brain protests. No, no I don’t, let’s be honest, not where myeloma is concerned. I have very few emotions surrounding myeloma. Of course, I strongly feel for and empathize with other suffering myeloma patients, but if I try to feel something for myself, I feel nothing. No fear, no anger, no sadness, no depression.

Final question for the day: are my cheerful attitude and quirky sense of humor simply a mask (in the sense of a Pirandellian mask)? I don’t think so, since I have been this way all my life, but I don’t know for certain. I have no definite answers, except that perhaps denial, if that is what it is, gives us a way of coping and trying to function on a daily basis. Perhaps it is not necessarily a bad thing…

Well, that’s it for now. Yesterday I discovered something new, so I have some research to do. 😉

When I signed up for two of the myeloma listservs more than a year ago, I met many wonderful people. Among them is a friend with MGUS, a curcumin-taker, who arrived Thursday in Rome. This is her first trip to Europe! She arrived in Florence yesterday and is staying with us. We hadn’t actually met until yesterday. Anyway, this is very very exciting!

After doing some sightseeing this morning, we returned home where I prepared my first curcumin mixture, my butter/curcumin/hot chocolate milk concoction. She tasted it and pronounced it very good. She was surprised. She thought it would taste terrible. She just told me, and I quote: “it tasted like pure chocolate, there was no aftertaste of curcumin.” I am quite pleased. 🙂

Anyway, we are busy, so I will stop here. More soon!