Pootren,
Sorry to hear about your dad's current situation. Why exactly is your doc saying your dad is "borderline" given he has multiple lytic lesions, etc?
The key things that folks tend to look at when evaluating myeloma are:
1. The M-spike (aka abnormal protein, paraprotein, M-protein) that shows up on the serum protein electrophoresis test.
2. The light chains and their K/L ratio.
3. For monitoring the CRAB criteria (hypercalcemia, renal issues, anemia, bone issues) via blood tests, one's hemoglobin, calcium, creatinine/BUN/eGFR/albumin are the typical serum markers to look at.
He does have a pretty high creatinine level and a low eGFR, which suggests he's got kidney issues as result of the multiple myeloma. This link explains GFR
http://nkdep.nih.gov/resources/explaining-kidney-test-results.shtml . A creatinine level of 176 umol/L (2.0 mg/dL) or greater represents renal insufficiency by myeloma standards (the "R" in the CRAB criteria), so he is still below that level, but seems to be heading in the wrong direction.
He also appears to be a bit anemic given his hemoglobin level, but doesn't meet the definition of having anemia by multiple myeloma standards (it would need to be at 113 g/L or lower to meet the "A" in the CRAB criteria).
And he has the lytic lesions going on. The fact they are on his spine is of concern since they can cause very debilitating spinal damage over time if they aren't treated.
Given he's got both cardiac and kidney issues going on along with the multiple myeloma diagnosis and issues, has the doctor ruled out amyloidosis as a potential accompanying disease? Amyloidosis occurs in about 15% of multiple myeloma patients over time and can often go undiagnosed (especially if you aren't working with a multiple myeloma specialist that's experienced enough to look out for it).
I'm not a doc by any stretch of the imagination and I really am not qualified to comment on treatment in the context of a pending bypass surgery. But I wonder if there is some reduced multiple myeloma treatment that might be possible in light of the pending bypass surgery?? I also don't know if initial treatment of the lesions with radiation might be appropriate under the circumstances, or perhaps starting only on a bone-strengthening drug like Zometa? Again, I may be completely off-base with these suggestions given his heart condition. Other folks on the forum with experience dealing with a cardiac comorbidity would be much better suited to comment than me.
Are you working a specialist that deals only with multiple myeloma (I know you've said before that your dad's doc is quite knowledgeable about multiple myeloma, but this fact alone doesn't make him a multiple myeloma specialist, who has the benefit from being involved in multiple myeloma research and seeing many difficult multiple myeloma cases on a daily basis)? Getting a second opinion from a multiple myeloma specialist might be your best bet under the circumstances. If you let us know what city your dad is in, folks can make some recommendations on where to seek out these specialists.
