[emmie]

Need help understanding lab work

by emmie on Tue Nov 22, 2011 9:22 pm

Hello, I have had a lot of blood and uring test recently and have been referred to an oncologist for further test.

I have Hepatitis C and have failed two rounds of Interferon/ribavirin treatment. I had bone pain in my shin bone and in my ribs but it was suspected to be side effects of the treatment. No further tests were done. I have been off treatment for almost 2 years. I moved and went to new doctor. The pain in leg was not present but the rib pain has remained and gotten worse making deep breaths a bit painful. It is in my back and side of right ribs.

This is information from my labs ~ could someone tell me if I should be concerned greatly?

blood for hep c-
mild elevation in protein levels
non-positive resuls suggesting auto immune disease or rheumatoid, lupus or other inflammatory process

Then they ran more test and these were results.

blood-
GAMMA 2,2
TOTAL PROTIEN 8,5
IGG 2560

urine-
Albumin 100.

I appreciate any help I can get to understand what these tests are saying.

Emmie

[emmie]

Re: Need help understanding lab work

by emmie on Tue Nov 22, 2011 9:26 pm

I forgot to add

I have sudden clammy sweats, night sweats, sudden weakness, vertigo *dizziness* and falling, severe fatigue. Fague discomfort, muscle cramping, intense headaches, constipation, ringing in ears at times.

[emmie]

Re: Need help understanding lab work

by emmie on Wed Nov 23, 2011 1:12 am

my concentration of M spike in the gamma region is 1.8 gm/dL

[Dr. Ken Shain]

Re: Need help understanding lab work

by Dr. Ken Shain on Fri Nov 25, 2011 9:02 pm

The M spike or monoclonal protein noted in your serum suggests that you may have some form of plasma cell disorder or other B cell disorder (lymphoma) especially with your Hep C history . However, by itself it only tells us that there is clonal population of cells making an antibody that should not be there.

Upon referral to an oncologist you will get a battery of adittional blood and urine tests (some repeats), imaging (at least bone survery, if not a CT scan or PET/CT), bone marrow biopsy and aspirate. Then more sense can be made of the M-spike and therapeutic disicions can be made. Watch or Treat depending on the additional findings.

[emmie]

Re: Need help understanding lab work

by emmie on Sat Nov 26, 2011 1:05 am

does the fact that the concentratioin of M SPIKE IN THE GAMMA REGION IS IGG KAPPA gm/dL
make any difference in what I may expect to hear?
I am trying to prepare myself for the meeting and want to have questions ready.

[Dr. Ken Shain]

Re: Need help understanding lab work

by Dr. Ken Shain on Sat Nov 26, 2011 11:55 am

To keep it relatively simple, plasma cell dyscrasias are the spectrum of myelomatous diseases including, but are not limited to, MGUS (monoclonal gammopathy of undetermined significance), smoldering (inactive) multiple myeloma (SMM), and active multiple myeloma. These disease states are defined by the M-spike, the percent myeloma cells in your bone marrow (identified by bone marrow biopsy and aspirate), and evidence of end organ damage.

MGUS is defined as M-spike <3gm/dl, percent plasma cells (myeloma cells) <10%, no end organ damage. This is a benign, premalignant condition that requires close monitoring, but no active therapy. It has a 1% per annum rate of progression to active myeloma.

Smoldering myeloma is defined by an M-spike >3gm/dl or percent plasma cells (myeloma cells) <10%, no end organ damage. This too is a premalignant condition that requires close monitoring, but no active therapy. It has a significantly higher rate of progression to active myeloma per year at 10% for the first 3-5 years. Following the initial few years the rate decreases to that of MGUS.

Active multiple myeloma is defined by the presence of end organ failure; CRAB(I) criteria- High Calcium, Renal (kidney) insufficiency, Anemia (low red blood cells), Boney lytic lesions, and increase rate of serious Infections. With an identifiable clonal population of myeloma cells (M-spike and plasma cells).

Staging is based on additional lab tests including beta2 microglobulin and albumin (for International Staging System (ISS)). As you can see, we only have part of the story at this time and cannot say much more until we have more information. Prognosis is based on ISS, genetic factors that will be identified from analysis of the myeloma cells from the bone marrow biopsy aspirate (cytogenetics and FISH- fluorescence in situ hybridization), and several other parameters.

So as you can see, the M-spike is only a part of your staging, diagnostic criteria, and prognostic criteria. Have any of you other labs been out of the ordinary- calcium, creatinine, Hgb (hemaglobin or hematocrit)? I just saw the symptoms that you listed. When are you scheduled to see your oncologist? Are these new or have they been going on for several weeks/months? If they are new (last several days or at least since you have seen your oncologist), please call your oncologist and make him/her aware of the current situation.

As stated earlier, with a hepatitis c infection you are at an increased risk for developing myeloma and/or non-hodgkin's lymphoma and should be monitored closely.

[emmie]

Re: Need help understanding lab work

by emmie on Sat Nov 26, 2011 9:24 pm

Thank you so much. You were very helpful. I have my appointments scheduled this week. The pain has been for a while, I thought it was my liver. The SOB got worse as pain increased.
I will post more tests results as I get them. These are the ones I remembered to ask for copies of... I will do better next time. Thank you again I feel better prepared.

[emmie]

Re: Need help understanding lab work

by emmie on Thu Dec 01, 2011 6:41 pm

I have been taking an herb called
AGARICUS BLAZEI MURILL FRUITBODY 800 MG 3X/DAY

at the advise of a naturopath so I was actively doing something while I waited for appointments

I just read online that this mushroom can cause terrible liver damage??? The naturopath knows I have stage 3 nodular cirrhosis Hepatitis C genotype 1

could I be doing damage to myself?


my total protien has gone from 9.0 to 8.5 in 10 days on it.

the IGG at 2560 what does that imply?

Thyroxine at 15.4 means what?

abnormal tests
BLOOD~
GAMMA
Total PROTEIN
IGG
Glucose
SGOT
total protein
Thyroxine
rheumatioid factor
SED RATE
MVP
Viral load

URINE~
albumin barely over top range
Protein-R barely over top range

and a 13 pound weight loss in one month ( I have done nothing to try to lose weight)

sleeplessness
Bad headaches that don't stop
eye vision keeps changing almost daily and sometime different from morning to evening
shoulder/neck PAIN
SOB
PAIN in ribs has deminished but still there (SINCE TAKING HERBAL FORMULA)
clammy sweats during day
weakness in general
weakness in legs
extreme fatigue
night sweats
nausea
constipation
stool is black ( is this due to that herbal mushroom supplement?)
abdominal discomfort
severe cramps in legs and feet

does this with the other information I've provided assist you in any better idea which I might have MGUS or SMOLDERING MYELOMA or MULTIPLE MYELOMA

If it is MgUS how long does it typically take to move into myeloma
if it is Smoldering Myeloma how long typically does it take to turn into myeloma

Will my liver be able to sustain the High Dose of Chemo required?
If not would they do a transplant prior or am I just out of luck?

I barely made it thru the interferon/ribivirin treatment being taken off twice due to wbc's bottoming out, sever malnutrition, they brought in an oncologist then to work with my WBC problem and he was able to restore it but NO More INTERFERON for me.
I lost ALL body hair
lost 50 lbs (medication induced anorexia)
and spent more time in the hospital than out
psycological/depression (induced by medication required medical intervention

I read online that interferon can actually help, prevent, slow down myeloma progression
if this is true could the difficulty I had achieving SVR and with the whole treatment in general be attributed to having had MGUS?

Thank you for your time and attention.
emmie