Just received a copy of my husband's test results and am waiting on the oncologist to call. Should there be concern?
I am always concerned, however the oncologist normally just says the numbers are stable compared to the last test. However, his overall health has declined to the point that he cannot get out of the bed now due to weakness, fatigue and blood pressure issues. Thanks for any advice.
Please note, we are not in active treatment and haven't been since December due to severe neuropathy.
I am only posting the results that are flagged.
Albumin 2.7
Gamma Globulin 2.0
M-Spike 1.4
A/G Ratio 0.6
Free Kappa Lt Chains, S - 24.41
Free Lambda Lt Chains, S - 469.93
Kappa/Lambda Ration, S - 0.05
RBC - 3.69
Hemoglobin 10.3
Hematocrit 32.3
Neutrophils 80
Lymphs 11
Lymphs (Absolute) 0.6
Creatinine, Serum 0.43
Bun/Creatinine Ratio 28
Chloride, Serum 96
Albumin, Serum 3.1
A/G Ratio 0.8
Immunoglobulin G QN, Serum 2272
Forums
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sharples74 - Name: JSmith
- Who do you know with myeloma?: Spouse
- When were you/they diagnosed?: Sept 2013
- Age at diagnosis: 60
Re: Latest test results - any cause for concern?
At a minimum, it looks like he is anemic (low hemoglobin, low RBC, low hematocrit), which would explain a lot about how he feels (fatigued, etc) .
Are you working with a multiple myeloma specialist? I see from your earlier posts that he was on Velcade and stopped because of neuropathy. Was he on subcutaneous Velcade (injections in the tummy) or an IV? Did you discuss alternative meds with your doc that weren't likely to cause neuropathy?
It would be helpful if you also include his last test results side-by-side before he started to feel so poor (which I assume was earlier this year?).
I'm not a doc, so please follow through with one.
Are you working with a multiple myeloma specialist? I see from your earlier posts that he was on Velcade and stopped because of neuropathy. Was he on subcutaneous Velcade (injections in the tummy) or an IV? Did you discuss alternative meds with your doc that weren't likely to cause neuropathy?
It would be helpful if you also include his last test results side-by-side before he started to feel so poor (which I assume was earlier this year?).
I'm not a doc, so please follow through with one.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Latest test results - any cause for concern?
Recent results compared to results from May test:
Recent results listed first with, May results after.
For some cases, results from February of this year also are added at the end.
Albumin 2.7 - 2.6
Gamma Globulin 2.0 (Feb: 1.9)
M-Spike 1.4
A/G Ratio 0.6
Free Kappa Lt Chains, S - 24.41
Free Lambda Lt Chains, S - 469.93 (Feb: 282.89)
Kappa/Lambda Ration, S - 0.05 (Feb: 0.06)
RBC - 3.69 - 4.52 (Feb: 4.31)
Hemoglobin 10.3 -12.5 (Feb: 12.8)
Hematocrit 32.3 - 40.3 (Feb: 38.5)
Neutrophils 80 - 80.4
Lymphs 11 - 10.4 (Feb: 13)
Lymphs (Absolute) 0.6 - 0.7
Creatinine, Serum 0.43 - 0.54 (Feb: < 0.01)
Bun/Creatinine Ratio 28 - 37.2
Chloride, Serum 96 - 97
Albumin, Serum 3.1
A/G Ratio 0.8
Immunoglobulin G QN, Serum 2272 - 2310 (Feb: 2086)
The May results listed a Osmolality of 272.3 but I don't see this on the July results.
Yes he took Velcade as an injection in the stomach. No other treatment options were discussed due to his poor overall health (stroke victim).
Please note I am not familiar with these test and don't understand what they mean other than the basic CBC.
I thought he was anemic as well but the family doctor not the oncologist seem to be concerned about it. They just say with all his medical issues, the test are pretty stable.
Thanks for any advice or help.
Moderator's Note: When available, we've also added results from a February series of lab results that Sharples74 posted here.
Recent results listed first with, May results after.
For some cases, results from February of this year also are added at the end.
Albumin 2.7 - 2.6
Gamma Globulin 2.0 (Feb: 1.9)
M-Spike 1.4
A/G Ratio 0.6
Free Kappa Lt Chains, S - 24.41
Free Lambda Lt Chains, S - 469.93 (Feb: 282.89)
Kappa/Lambda Ration, S - 0.05 (Feb: 0.06)
RBC - 3.69 - 4.52 (Feb: 4.31)
Hemoglobin 10.3 -12.5 (Feb: 12.8)
Hematocrit 32.3 - 40.3 (Feb: 38.5)
Neutrophils 80 - 80.4
Lymphs 11 - 10.4 (Feb: 13)
Lymphs (Absolute) 0.6 - 0.7
Creatinine, Serum 0.43 - 0.54 (Feb: < 0.01)
Bun/Creatinine Ratio 28 - 37.2
Chloride, Serum 96 - 97
Albumin, Serum 3.1
A/G Ratio 0.8
Immunoglobulin G QN, Serum 2272 - 2310 (Feb: 2086)
The May results listed a Osmolality of 272.3 but I don't see this on the July results.
Yes he took Velcade as an injection in the stomach. No other treatment options were discussed due to his poor overall health (stroke victim).
Please note I am not familiar with these test and don't understand what they mean other than the basic CBC.
I thought he was anemic as well but the family doctor not the oncologist seem to be concerned about it. They just say with all his medical issues, the test are pretty stable.
Thanks for any advice or help.
Moderator's Note: When available, we've also added results from a February series of lab results that Sharples74 posted here.
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sharples74 - Name: JSmith
- Who do you know with myeloma?: Spouse
- When were you/they diagnosed?: Sept 2013
- Age at diagnosis: 60
Re: Latest test results - any cause for concern?
Sharples,
For the others that may comment on this post, I'm also including this earlier post to help others understand that there is more going on here than multiple myeloma.
https://myelomabeacon.org/forum/post20170.html#p2017
Clearly, some of these values are trending in a negative direction (such as the ones I mentioned earlier). I'm just not qualified to say which may be mm-related versus the stroke and/or other medical conditions, so I will refrain from commenting.
Again, I'd really encourage you to seek out an oncologist that specializes in multiple myeloma to help sort out that piece of the puzzle (if you let us know where you live, folks on this forum can likely point you in the right direction).
For the others that may comment on this post, I'm also including this earlier post to help others understand that there is more going on here than multiple myeloma.
https://myelomabeacon.org/forum/post20170.html#p2017
Clearly, some of these values are trending in a negative direction (such as the ones I mentioned earlier). I'm just not qualified to say which may be mm-related versus the stroke and/or other medical conditions, so I will refrain from commenting.
Again, I'd really encourage you to seek out an oncologist that specializes in multiple myeloma to help sort out that piece of the puzzle (if you let us know where you live, folks on this forum can likely point you in the right direction).
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Latest test results - any cause for concern?
We are from West Virginia.
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sharples74 - Name: JSmith
- Who do you know with myeloma?: Spouse
- When were you/they diagnosed?: Sept 2013
- Age at diagnosis: 60
Re: Latest test results - any cause for concern?
This link discusses some specialist options for you in and around Virginia....
https://myelomabeacon.org/forum/centers-of-excellence-t3088.html?hilit=specialist%20virginia#p17319
https://myelomabeacon.org/forum/centers-of-excellence-t3088.html?hilit=specialist%20virginia#p17319
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Latest test results - any cause for concern?
Just to summarize a few things to help out with the discussion here ...
Sharples74, you mentioned in a previous posting that your husband is being seen by a myeloma specialist. You indicated that was the case in this posting. Is that correct?
If so, is your myeloma specialist at cancer center, or is the specialist perhaps a hematologist/oncologist in a group practice ... or perhaps even a single physician practice?
(Note, as well, that we've added to Sharples74's original posting above some lab results from February that she posted earlier.)
Also, just to make sure we fully understand your husband's treatment history, he was diagnosed last September, and he has only been treated with Velcade since then. Is that correct? Did he receive any dexamethasone (Decadron) along with the Velcade?
Just to check, Sharples74, has your husband's doctor ever discussed whether there are any insurance restrictions which may be affecting the options that are able to be considered for your husband?
We ask because, absent such restrictions, it would seem that there would be a wide range of alternatives that your doctor could pursue for your husband given that he's only been treated with Velcade thus far.
Finally, Sharples74, you mention that your husband has had a stroke. Does he have any other health issues that might affect what he could be treated with -- for example, heart issues, or diabetes, etc.?
We're sorry to ask all these questions, but hopefully they will help all of us help you better.
Sharples74, you mentioned in a previous posting that your husband is being seen by a myeloma specialist. You indicated that was the case in this posting. Is that correct?
If so, is your myeloma specialist at cancer center, or is the specialist perhaps a hematologist/oncologist in a group practice ... or perhaps even a single physician practice?
(Note, as well, that we've added to Sharples74's original posting above some lab results from February that she posted earlier.)
Also, just to make sure we fully understand your husband's treatment history, he was diagnosed last September, and he has only been treated with Velcade since then. Is that correct? Did he receive any dexamethasone (Decadron) along with the Velcade?
Just to check, Sharples74, has your husband's doctor ever discussed whether there are any insurance restrictions which may be affecting the options that are able to be considered for your husband?
We ask because, absent such restrictions, it would seem that there would be a wide range of alternatives that your doctor could pursue for your husband given that he's only been treated with Velcade thus far.
Finally, Sharples74, you mention that your husband has had a stroke. Does he have any other health issues that might affect what he could be treated with -- for example, heart issues, or diabetes, etc.?
We're sorry to ask all these questions, but hopefully they will help all of us help you better.
Re: Latest test results - any cause for concern?
He is being treated at the David Lee Cancer Center in Charleston, WV by Dr. Khalid. He received Velcade and 40 mg of Decadron with each treatment of Velcade. The treatment was stopped in December of 2013 (started in October).
Note his overall health is not good from the brain stem stroke in 2011. He has a feeding tube as he cannot swallow due to the stroke. He also couldn't walk and suffered some neuropathy due to the stroke. No issues with his heart or diabetes. After the treatment, the neuropathy got so much worse causing numbness of his feet up to the knees.
During the past month, he has developed blood pressure issues, he is now confined to the bed as he gets really dizzy when he tries to sit on the side of the bed and blood pressure drops significantly..sometimes as low as 70/40 but goes back up as soon as he lays down. His feet are starting to turn.
We have Home Health coming 2-3 times a week for PT and they do all the blood work, etc. We have no issues with our insurance, he has Medicare and a secondary coverage that covers pretty much anything.
And I should add that he sleeps most of the day as he complains of being really tired. He doesn't complain of a lot of pain, just occasionally.
Thanks so much.
Note his overall health is not good from the brain stem stroke in 2011. He has a feeding tube as he cannot swallow due to the stroke. He also couldn't walk and suffered some neuropathy due to the stroke. No issues with his heart or diabetes. After the treatment, the neuropathy got so much worse causing numbness of his feet up to the knees.
During the past month, he has developed blood pressure issues, he is now confined to the bed as he gets really dizzy when he tries to sit on the side of the bed and blood pressure drops significantly..sometimes as low as 70/40 but goes back up as soon as he lays down. His feet are starting to turn.
We have Home Health coming 2-3 times a week for PT and they do all the blood work, etc. We have no issues with our insurance, he has Medicare and a secondary coverage that covers pretty much anything.
And I should add that he sleeps most of the day as he complains of being really tired. He doesn't complain of a lot of pain, just occasionally.
Thanks so much.
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sharples74 - Name: JSmith
- Who do you know with myeloma?: Spouse
- When were you/they diagnosed?: Sept 2013
- Age at diagnosis: 60
Re: Latest test results - any cause for concern?
Hi, just read your posting and the links to other posts you've made. We seem to have a few things in common so I thought I'd offer my 2 cents worth and hope its helpful.
My husband's health issues prior to multiple myeloma diagnosis were also severe. The last 3 years have been a trial for sure. The biggest help for us, though, is where he is treated. We go to the University of Iowa for all major issues. He does have a primary care doctor here in town. And we have had consults at Mayo. But I can't emphasize enough the value of having his heart specialist and his oncologist being located in the same facility. They are easily able to share all test results for comparison, and as colleagues they confer with one another on the issues that affect him in both areas.
My husband is only 59 years old. His doctors consider him too young to just say treatment is not an option. And, just to clarify, my husband has suffered cardiac arrest, with a resulting brain injury. Multiple stents, triple bypass. delirium at the time of multiple myeloma diagnosis. Also kidney issues, but not to an extreme. He was anemic at diagnosis with a creatinine of 2.5. Treatment was with sub q Velcade and IV Cytoxan. No dex due to his delirium. Zometa was added but is currently on hold due to rising creatinine.
He is off treatment and has no detectable M spike. Transplant was ruled out due to worsening heart issues. We are currently waiting for his kidneys to recover a little more so he can receive 4 more stents to his heart. The cardiologist at Mayo said no to the transplant and wanted only medical treatment for the heart issue. Our cardiologist at the University of Iowa said they wanted to do angio to see the extent of the new damage (it is believed the Velcade has caused the further damage). The goals were to repair the heart as much as possible to improve his quality of life, and to also make him transplant eligible. I'm not sure I see that happening.
But it is their collaboration and commitment to quality of life that impresses me. I think you need this in your efforts to improve your husbands health.
One last point, be strong, and be tough. We so often sit on our hands and let doctors do what they do. But never underestimate the power of a good patient advocate.
My husband's health issues prior to multiple myeloma diagnosis were also severe. The last 3 years have been a trial for sure. The biggest help for us, though, is where he is treated. We go to the University of Iowa for all major issues. He does have a primary care doctor here in town. And we have had consults at Mayo. But I can't emphasize enough the value of having his heart specialist and his oncologist being located in the same facility. They are easily able to share all test results for comparison, and as colleagues they confer with one another on the issues that affect him in both areas.
My husband is only 59 years old. His doctors consider him too young to just say treatment is not an option. And, just to clarify, my husband has suffered cardiac arrest, with a resulting brain injury. Multiple stents, triple bypass. delirium at the time of multiple myeloma diagnosis. Also kidney issues, but not to an extreme. He was anemic at diagnosis with a creatinine of 2.5. Treatment was with sub q Velcade and IV Cytoxan. No dex due to his delirium. Zometa was added but is currently on hold due to rising creatinine.
He is off treatment and has no detectable M spike. Transplant was ruled out due to worsening heart issues. We are currently waiting for his kidneys to recover a little more so he can receive 4 more stents to his heart. The cardiologist at Mayo said no to the transplant and wanted only medical treatment for the heart issue. Our cardiologist at the University of Iowa said they wanted to do angio to see the extent of the new damage (it is believed the Velcade has caused the further damage). The goals were to repair the heart as much as possible to improve his quality of life, and to also make him transplant eligible. I'm not sure I see that happening.
But it is their collaboration and commitment to quality of life that impresses me. I think you need this in your efforts to improve your husbands health.
One last point, be strong, and be tough. We so often sit on our hands and let doctors do what they do. But never underestimate the power of a good patient advocate.
Re: Latest test results - any cause for concern?
I forgot to ask if your husband is working with a speech therapist for his swallowing issues? Being able to return to taking any food by mouth will be a great improvement to quality of life. I also work in a skilled care unit and have seen many people return to near normal swallowing following strokes.
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