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Dhruv, age 32, diagnosed December 2017

by DDstrong on Thu Feb 08, 2018 3:11 am

Hi all,

I'm so glad I found this community. Compelling reading, lots of hope, and so informative.

Multiple myeloma is very new to me, so I don't have much to contribute as yet, but I thought I would introduce myself and provide the basics so as to get more engaged.

My name is Dhruv, I'm 32 and live in Dubai. I was diagnosed in December 2017, and the story goes something like this:

  • I had been sickly on and off through the year (getting infections, bugs, and the like)
  • Mild lower back pain that would surface now and again; I always thought it might have to do with posture / sitting at work or how I sleep
  • Got nosebleeds a couple of times
  • I'm basically fairly fit, eat well, and so on, but had been feeling less "fit" recently; not looking forward to climbing a flight of stairs, not able to do much the few times I went to the gym, happy to couch potato most weekends.
One night in early December, I had severe pain in the left side of my back, radiating to the front. Tried all manner of things all night, but the pain intensified (I also took an ibuprofen, an NSAID, which is apparently a big no-no). Went to the ER and was admitted for suspected kidney stones (they gave me more NSAIDs).

Once they ran my blood (or tried to; the blood was so viscous that they couldn't get any readings all day), they found my creatinine to be very high and hemoglobin low (~8). I was immediately put under the care of a hematologist and a nephrologist; they suspected multiple myeloma from the beginning and confirmed it 2 days later with a bone marrow biopsy.

I was immediately put on Velcade, Revlimid, and dexamethasone (VRD). The kidney failure has been challenging, and I have never been on the full dose of Revlimid. In fact, in early January, once the creatinine started rising again, I have been on cyclophosphamide instead of the Rev­limid. We restarted Revlimid about 2 weeks ago (10 mg daily since January 25) and this would be my week off.

The creatinine has been consistently dropping every week and is now at around 1.5 mg/dl.

I have IgG kappa myeloma; most recent readings had IgG at 6700 mg/dL and free kappa light chains at 1870 mg/L.

Aside from this, I have a number of masses (extramedullary plasmacytomas) in and around my intestines. A biopsy confirmed these were myeloma (three 5-6 cm diameter masses, and two smaller 1.5 cm lesions).

The FISH panel revealed three 'abnormalities': translocation on t(4,14), t(14,16) and "a deletion of MAF consistent with a loss of 16q".

I have been coping pretty well with the medications; there are side effects and a lot of them, but over time I feel my body is becoming accustomed to the treatment: less fatigue, back pain is mild, and other side effects (neuropathy, constipation etc) are quite sporadic. I'm still anemic (hemoglobin ~8 g/dL), WBC, and neutrophils are low but holding, and platelet count is low (those haven't changed in the past two months).

That's all from me for now. There's obviously a lot more going on in the background. Talk of transplants, other medications, and so on. As I said before, this is all so new. I hope to learn from everyone here and look forward to some engaging discussions as I navigate through this new and still surreal world.

DDstrong
Name: Dhruv D
When were you/they diagnosed?: December 2017
Age at diagnosis: 32

Re: Dhruv, age 32, diagnosed December 2017

by TerryH on Thu Feb 08, 2018 10:27 am

Welcome to the forum, Dhruv. As is often said here, I'm sorry that you have to join this sort of community, but I'm sure you'll find it a great resource.

It's good that you seem to be regaining kidney function. It would be great if you could avoid any long-term damage to them.

It looks like you had a really high M-spike at diagnosis, given how viscous your blood was and the fact that your M-spike is still around 6 g/dL after a month or so of treatment. Do you recall how high your M-spike and kappa level were when you were diagnosed? I'm just curious what sort of M-spike can lead to blood being so viscous.

I hope you respond well to treatment and that the side effects are limited and manageable. Good luck!

TerryH

Re: Dhruv, age 32, diagnosed December 2017

by michaelgreer on Thu Feb 08, 2018 1:01 pm

Welcome to the forum.

I had some similar issues when I was diagnosed, but found out the creatinine numbers were from all the ibuprofen I’d been consuming for about 9 months. When I stopped, the levels started to come down.

I also am on Velcade, dex, and Revlimid, two weeks on then one week off. Once my hemoglobin rose to near normal levels, my anemia disappeared, and I felt better than I had in months. Hopefully that will also be your experience.

michaelgreer
Who do you know with myeloma?: Self
When were you/they diagnosed?: 10/25/17
Age at diagnosis: 68

Re: Dhruv, age 32, diagnosed December 2017

by DDstrong on Thu Feb 15, 2018 2:14 am

Hi Terry and michaelgreer,

Thanks for the welcome.

Terry - It's been quite a challenge getting readings on the IgG and kappa levels since diagnosis. The results varied (and conflicted) a lot, We got feedback from the labs that they had to dilute the blood, which increases errors, etc. So not exactly sure what the readings were at diagnosis; can't be confident of the results.

We do have an established process now (heparinized collection tubes, specific instructions to the lab, etc.) and are tracking the levels every two weeks.

DDstrong
Name: Dhruv D
When were you/they diagnosed?: December 2017
Age at diagnosis: 32


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