I was hoping someone might help me understand/comment on the following:
I am 45 and have been in reasonably good health, but over the last three or so months I have had virulent flu-like illnesses several times. Among other symptoms, I was having a lot of burning pain in my flanks, sternum, back, and arms. My doctors in Georgia, where I used to live, could never figure out what was going on.
I recently moved to New York, and I have continued to feel fatigued, etc., and susceptible to upper respiratory infections. I have also developed pain (not terrible, but bad enough that it nags me all the time and sometimes wakes me up) in my back, ribs, sternum, and hips. I ordered my medical records from Georgia to establish care here, and discovered that my RBC, HGB, and HCT have been very mildly low for months (by which I mean, for example, RBC of 4.18, HGB of 12.8, HCT of 38.2). Sometimes, my WBC and/or one of my lymph readings has also been very mildly low (for instance, WBC of 3.6, Monocytes Absolute at 160).
My kidney function was also down for months, ranging from a GFR of 58 to a low of 55 (this has since rebounded into the mid-70s).
Finally, a chest and abdominal CT from early May showed lumbar and thoracic spondylosis, as well as some degenerative changes to the SI joints. No suspicious osseus lesions were noted.
These readings, coupled with my fatigue and bone pain, and added to the possibility that my father may have had multiple myeloma when he passed (diagnosis was not pursued as he was in very poor health and expected to die imminently from other causes), led my new primary care to run some multiple myeloma tests.
The serum electrophoresis was normal. The UPEP showed "a slight restriction in the gamma range that may indicate the presence of a monoclonal protein." So, serum and urine immunofixation were ordered.
Both the serum and urine immunofixation tests came back completely normal: no IgM, IgA, IgG, kappa, or lambda bands that would indicate the presence of a monoclonal protein. In fact, the only protein observed in my urine was albumin.
Given all of the above, I have two questions for those who know more than I do:
- My primary care doctor did not give me any instructions re what to eat or drink, what meds to take or not take, during the 24-hour urine catch. So I ate, drank, and medicated as normal, including having some wine in the evening. Subsequently, I read that some medications and even alcohol can affect some test results. Is there any reason to be concerned that these otherwise very positive IFE results may have been tainted by medications or alcohol?
- At this point, does the possibility of multiple myeloma need to be further pursued? I am inclined to ask for a referral to a hematologist because of the continuing fatigue and mild anemia, anyway, but I suppose I am wondering if there is a realistic possibility that I am a true "nonsecretor" so that the above tests may have missed something. Does anyone have an opinion on what the next steps should be?
