Summer & Zometa

Summer is here!

My plans for this summer are to….
Work on my fitness ;)
In addition, I have my 6 month follow up for the Natural History Study of MGUS & SMM in August and my 3 month labs and appointment with Dr. R in July. I received my MD note from my last appointment in April. Some of the statements are a little unsettling… I guess I knew all of the information written but it’s hard to see in black and white. A few quotes:

“Elizabeth is clinically stable and doing well overall. It should be noted that she has been fully evaluated by my colleagues in Endocrinology and she does not have any other explanation for her osteopenia. This, therefore, raises the possibility of early myeloma-related bone disease. At this juncture, bisphosphonate therapy has not been recommended by her endocrine consult team because of the risk to any potential pregnancy that she is planning. At this juncture, therefore, Elizabeth is not keen to proceed with bisphosphonate therapy.”

“Elizabeth otherwise continues to do relatively well and in this context, I have recommended she continue with her regimen of simple analgesics for antipyretic effects. In this regard, aspirin may be an excellent choice. This may have the additional advantage of being useful as an anti-inflammatory and thus has some clinical benefit for her. In this context, we have recommended two to three tablets a day provided GI tolerance permits.
Otherwise, we will follow a policy of careful observation. In terms of her bone disease, this will require simply careful observation at this stage given her reluctance to in any way consider bisphosphonate at this point in time.”
It should be noted that she will continue on vitamin D and other supplements as needed. Elizabeth will return to see me again in the next several months. We will continue to monitor her course very carefully and she knows to call should she have outstanding issues or concerns”.

Sort of feel blindsided by this note because I thought everyone was in agreement that I would not start zometa at this time. This makes it sound like I’m refusing to start, which makes me uneasy. Definitely need to inquire a bit more about this in July.