My wife has had thoracic and lumbar pain for 9 weeks; she has had right iliac crest pain for 6 months. In the past 2 or 3 weeks she has also been experiencing pain in her ribs.
She went to the doctor after three weeks of back pain and her x-ray showed no abnormalities. Three weeks after that, her right hip was x-rayed and again it showed no abnormalities.
Her blood work is all in the normal ranges, including her SED rate, which is 17. The only significant change was her calcium level, that went from 9.0 in July 2013 to 9.4 in July 2014. When it was retested in January, 2015, it was still 9.4.
Her doctor is not even considering multiple myeloma. She thinks it is anxiety. We read that 20 percent of the people who have been diagnosed with multiple myeloma have x-rays that are normal.
How likely is it that my wife can have back pain and still have normal x-rays? Is it possible that the 20 percent with normal x-rays are not experiencing back pain?
One more thing, for the past 4 months she has also had pain in the pad of her foot behind the big toe. It comes and goes, but is painful particularly after walking.
Please share your thoughts, comments and guidance. Thank you.
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Re: Seeking guidance for my wife
Hello sadlerst,
I'm sorry to hear about the concern you and your wife have about the pain she has been experiencing.
A lot of your concern appears to be based on the your wife's blood calcium levels. However, a value of 9.4 is not unusually high for an adult. In fact, it's within the normal range.
In addition, there are a number of different things than could cause blood calcium tests to vary, including simple things like a change in diet or the vitamin and mineral supplements a person takes.
Some useful blood test results to look at to determine if your wife possibly has myeloma would be (in addition to calcium) her hemoglobin level and her creatinine level. What were these values on her latest blood tests?
Also, has your wife had any tests done to check whether she has any of the proteins in her blood that might suggest myeloma. Tests that I have in mind are things like:
Finally, as far imaging is concerned, x-rays are a good place to start, and it's good that your wife doesn't have any signs of bone lesions in the x-rays she's had done so far. However, MRIs will show more what is going on inside the bones, and a PET scan, or PET/CT would really help detect whether there is any myeloma-related activity in the bones. The PET-type scans, however, might be hard to organize without really good cause. So MRIs of the back and pelvic areas, with a request that the radiologist look for signs of "focal lesions", probably would be the best starting point.
Good luck, and let us know if you have anything else you'd like to know.
I'm sorry to hear about the concern you and your wife have about the pain she has been experiencing.
A lot of your concern appears to be based on the your wife's blood calcium levels. However, a value of 9.4 is not unusually high for an adult. In fact, it's within the normal range.
In addition, there are a number of different things than could cause blood calcium tests to vary, including simple things like a change in diet or the vitamin and mineral supplements a person takes.
Some useful blood test results to look at to determine if your wife possibly has myeloma would be (in addition to calcium) her hemoglobin level and her creatinine level. What were these values on her latest blood tests?
Also, has your wife had any tests done to check whether she has any of the proteins in her blood that might suggest myeloma. Tests that I have in mind are things like:
- Immunoglobulin levels (IgG, IgA, IgM, etc.)
- Free light chain levels (based on the "Freelite" assay)
- Serum protein electrophoresis (SPEP)
- Serum immunofixation (serum IFE)
Finally, as far imaging is concerned, x-rays are a good place to start, and it's good that your wife doesn't have any signs of bone lesions in the x-rays she's had done so far. However, MRIs will show more what is going on inside the bones, and a PET scan, or PET/CT would really help detect whether there is any myeloma-related activity in the bones. The PET-type scans, however, might be hard to organize without really good cause. So MRIs of the back and pelvic areas, with a request that the radiologist look for signs of "focal lesions", probably would be the best starting point.
Good luck, and let us know if you have anything else you'd like to know.
Re: Seeking guidance for my wife
Thank you for your response and the helpful information.
I do have another question. During the past six months, my wife, who previously had not been eating dairy, has started eating Greek yogurt and cheese. Could these changes be the cause of her calcium level increasing from 9.0 to 9.4 from July 2013 to July 2014?
Also, my wife had been anemic about five years ago prior to menopause, when her periods became heavy and the cycle was 3 weeks instead of 4. Since that time, she has taken iron supplements a few times a week. She is 52 years old. She became menopausal at the beginning of this year and lowered the iron supplements to twice a week.
As far as her creatinine levels - prior to 2012, she was consistently 1.0. In 2013, her lab switched to the IDMS traceable method, and her results were 0.54 in July 2013, 0.71 in July 2014, and 0.69 in January 2015.
What are your thoughts on the above information?
I want to add that my wife has not eaten any form of red meat (beef, pork, lamb, etc.) in more than 25 years.
I do have another question. During the past six months, my wife, who previously had not been eating dairy, has started eating Greek yogurt and cheese. Could these changes be the cause of her calcium level increasing from 9.0 to 9.4 from July 2013 to July 2014?
Also, my wife had been anemic about five years ago prior to menopause, when her periods became heavy and the cycle was 3 weeks instead of 4. Since that time, she has taken iron supplements a few times a week. She is 52 years old. She became menopausal at the beginning of this year and lowered the iron supplements to twice a week.
As far as her creatinine levels - prior to 2012, she was consistently 1.0. In 2013, her lab switched to the IDMS traceable method, and her results were 0.54 in July 2013, 0.71 in July 2014, and 0.69 in January 2015.
What are your thoughts on the above information?
I want to add that my wife has not eaten any form of red meat (beef, pork, lamb, etc.) in more than 25 years.
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