So I had my 3 month appointment with Dr. R last week. Overall… it was fine. My m-spike was up a bit but that has been the trend for the last 4 years. My 24 hour urine was negative for monoclonal protein – but still have to do another collection in 3 months…grrr. My IgG was up a bit, lambda was up a bit, FLC ratio down a bit. The rest of my numbers that are sometimes high/low are still high/low. HOWEVER, my B2M that was higher than usual in April and was at 2.4 was down to 1.8. Very happy about that. Dr. R says everything overall is “stable”. The devil is in the details. ;)
I had another discussion with Dr. R in regards to bisphosphonates as I have low bone density (osteopenia) in my spine. I am not starting bisphosphonates yet but I just wanted to clarify his recommendations for me. He did confirm that he would recommend zometa infusions for me every 3 months. He said that bisphosphonates do help prevent bone involvement and prolong survival but the studies have been “mixed” as to whether or not bisphosphonates help prevent progression to symptomatic myeloma from the precursor states. He’s still mainly concerned about my recurrent fevers.
I also asked him about a study I had found: Timing of acquisition of deletion 13 in plasma cell dyscrasias is dependent on genetic context. This study suggests a possible role of Δ13 in the transition from MGUS to MM specifically in cases with t(11;14) or t(6;14). Well, I have monosomy 13 and t(11,14) and I showed him the paper on my phone. He wrote down the author and study on my visit note and said that he would, “look into it.” However, he said that the study was 4 years old (2009) and he hasn’t “heard much about it since.” So. Yeah. We’ll see.
As I wrote in my other post, Mind Body Medicine for MGUS and SMM, we also discussed the study starting at MGH/BHI using their 3RP program for patients with MGUS and SMM.
Overall… a good visit. At the end Dr. R said I need to just, “Keep on truckin’! ” Heh.
I saw this picture posted on FB and it made me laugh. .