Hi! I am a 60 year old woman who just had cataract surgery. A day after the surgery, I suffered complete and unexplained vision loss in the surgical eye. Much testing was done to see what might have caused the problem, and an MRI done as part of the testing showed abnormal bone marrow. So a bone marrow biopsy has been strongly recommended.
I have no obvious symptoms of multiple myeloma AT ALL! No broken bones or lesions, no other test results indicating any problem, I'm almost never sick. I'm very reluctant to have the biopsy.
One possible explanation for the loss of vision was an allergic reaction to the topical anesthetic used, and I understand that the same anesthetic (lidocaine) would be used for the biopsy. And, since I have no symptoms, I can't think they would do any kind of treatment at this point anyway.
I have had a bone scan and skeletal survey, which were perfectly normal. So I'm hoping people with experience can offer an opinion.
Even if the bone marrow shows myeloma, without symptoms, are they going to do any more than just watch for something to happen?
Thanks - I'm glad to have found this forum!
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Re: Bone marrow biopsy recommended, but no myeloma symptoms
Hello Octavia,
I'm sorry to hear about the problems with your eye.
I just want to be sure you truly have no symptoms of myeloma. Have you had blood testing done to test your hemoglobin, creatinine, and calcium levels? If so, did those results come back as normal.
More importantly, have you had serum protein electrophoresis (SPEP) and serum immunofixation (SIFE) done, or the urine equivalents, usually involving a 24-hour urine collection?
Finally, have you had your serum (blood) free light chain levels checked?
These are important tests to determine if you have early signs of myeloma.
Even if all these tests are clear, however, if there are signs of lesions on an MRI, this can be an important sign of myeloma as well. The results could be signs of very early stage-myeloma or, if there are a number of abnormal areas on the scan, the disease could be a bit more advanced.
The only way to truly understand if the lesions are myeloma-related is to do a bone marrow biopsy.
I would imagine that your physicians can arrange for a topical anesthetic other than lidocaine, and there also are options for doing light, or full, sedation during a bone marrow biopsy. It would be useful, however, to have the biopsy done by someone who regularly does such biopsies.
Also, if you are near a major cancer center, it would be very helpful to have your case referred to a myeloma specialist. This is a hematologist-oncologist who focuses almost exclusively on treating and researching multiple myeloma and related plasma disorders. A standard hematologist-oncologist is not a myeloma specialist -- he or she will see patients with many different blood cancers, not just myeloma.
Here is a good update on the current diagnostic criteria for multiple myeloma,
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
I am sure you will have more questions, so please let us know how we can be of more help.
Best of luck to you.
I'm sorry to hear about the problems with your eye.
I just want to be sure you truly have no symptoms of myeloma. Have you had blood testing done to test your hemoglobin, creatinine, and calcium levels? If so, did those results come back as normal.
More importantly, have you had serum protein electrophoresis (SPEP) and serum immunofixation (SIFE) done, or the urine equivalents, usually involving a 24-hour urine collection?
Finally, have you had your serum (blood) free light chain levels checked?
These are important tests to determine if you have early signs of myeloma.
Even if all these tests are clear, however, if there are signs of lesions on an MRI, this can be an important sign of myeloma as well. The results could be signs of very early stage-myeloma or, if there are a number of abnormal areas on the scan, the disease could be a bit more advanced.
The only way to truly understand if the lesions are myeloma-related is to do a bone marrow biopsy.
I would imagine that your physicians can arrange for a topical anesthetic other than lidocaine, and there also are options for doing light, or full, sedation during a bone marrow biopsy. It would be useful, however, to have the biopsy done by someone who regularly does such biopsies.
Also, if you are near a major cancer center, it would be very helpful to have your case referred to a myeloma specialist. This is a hematologist-oncologist who focuses almost exclusively on treating and researching multiple myeloma and related plasma disorders. A standard hematologist-oncologist is not a myeloma specialist -- he or she will see patients with many different blood cancers, not just myeloma.
Here is a good update on the current diagnostic criteria for multiple myeloma,
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
I am sure you will have more questions, so please let us know how we can be of more help.
Best of luck to you.
Re: Bone marrow biopsy recommended, but no myeloma symptoms
I had all those tests, and everything was normal. Also, I have no bone lesions at all. Just abnormal bone marrow cells. I just really don't want to do the biopsy.
I was going to do it a few weeks ago. I was actually lying on the exam table in a hospital gown, the instruments were at the ready, and the oncologist said she didn't really think I needed it but would do it if I wanted. Well, I said no thanks and got up and left. Then she talked to another radiologist and decided it should be done after all.
Thanks for your response! I will call her tomorrow and ask some more questions. I was so stunned when she told me it needed to be done I couldn't think of what to ask!
I was going to do it a few weeks ago. I was actually lying on the exam table in a hospital gown, the instruments were at the ready, and the oncologist said she didn't really think I needed it but would do it if I wanted. Well, I said no thanks and got up and left. Then she talked to another radiologist and decided it should be done after all.
Thanks for your response! I will call her tomorrow and ask some more questions. I was so stunned when she told me it needed to be done I couldn't think of what to ask!
Re: Bone marrow biopsy recommended, but no myeloma symptoms
That would be very confusing if she said you should have a BMB and then said she didn't know why you were having a BMB.
It sounds like they found a paraprotein in your blood. They would not do a BMB without there being a sign of this. Some refer to this as your m-spike. Was there any discussion of this?
It sounds like they found a paraprotein in your blood. They would not do a BMB without there being a sign of this. Some refer to this as your m-spike. Was there any discussion of this?
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Toni - Name: Toni
- Who do you know with myeloma?: self - MGUS
- When were you/they diagnosed?: April 2014
- Age at diagnosis: 51
4 posts
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