I'm going to Jamaica next spring and wanted to know what precautions I should take as someone with smoldering multiple myeloma.
My primary care physician said that I should get the hepatitis A vaccine before I go. However, are there any other vaccines that I should get given my diagnosis?
The CDC recommended a dose of immunoglobulin for those with compromised immune systems. I'm not sure if I fit that category. Do I?
Any other special precautions I should take (above and beyond what most healthy people would take anyway)?
Thanks,
FC
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FingersCrossed - Name: FingersCrossed
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Oct 2014 (Smoldering)
- Age at diagnosis: 44
Re: Travel to Caribbean and vaccines
FC,
Just the fact that you are smoldering doesn't really convey whether your immune system is significantly compromised or not. I'm smoldering and I'm not at all worried about getting infections during my foreign travels and/or overseas flights. But then again, all the healthy components of all of my immunoglobulin levels are quite fine – which is not a given for every smoldering multiple myeloma patient.
To see if you should be concerned at all and whether you would benefit from IVIG treatment, you would need to first calculate your healthy, polyclonal immunoglobulin IgG level to see if your immune system is significantly compromised or not and whether you would benefit from IVIG treatment. I would also suggest looking at your CBC results to see how your absolute lymphocyte level, etc is doing. I would also look at your IgA and IgM levels. But keep in mind that IVIG is made up primarily of IgG, and IVIG treatment won't help counter low IgM and IgA levels as much as it will a low IgG level.
Since I believe you have IgG type multiple myeloma, you would figure out your healthy IgG level by simply subtracting your M-spike value from your total IgG level. You will have to first normalize the units of measure for your M-spike and IgG before doing this simple math (typical units for an M-spike are g/dL; typical units for IgG are mg/dL.; 1 g/dL = 1000 mg/dL).
Then see if that calculated IgG number is squarely within your normal IgG range (which can be found on your quantitative IgG test result). Then ask yourself if you are currently prone to getting infections or getting sick more often or not since getting your smoldering multiple myeloma diagnosis. At least that is what I would do in addition to asking my onc for his/her opinion.
Just the fact that you are smoldering doesn't really convey whether your immune system is significantly compromised or not. I'm smoldering and I'm not at all worried about getting infections during my foreign travels and/or overseas flights. But then again, all the healthy components of all of my immunoglobulin levels are quite fine – which is not a given for every smoldering multiple myeloma patient.
To see if you should be concerned at all and whether you would benefit from IVIG treatment, you would need to first calculate your healthy, polyclonal immunoglobulin IgG level to see if your immune system is significantly compromised or not and whether you would benefit from IVIG treatment. I would also suggest looking at your CBC results to see how your absolute lymphocyte level, etc is doing. I would also look at your IgA and IgM levels. But keep in mind that IVIG is made up primarily of IgG, and IVIG treatment won't help counter low IgM and IgA levels as much as it will a low IgG level.
Since I believe you have IgG type multiple myeloma, you would figure out your healthy IgG level by simply subtracting your M-spike value from your total IgG level. You will have to first normalize the units of measure for your M-spike and IgG before doing this simple math (typical units for an M-spike are g/dL; typical units for IgG are mg/dL.; 1 g/dL = 1000 mg/dL).
Then see if that calculated IgG number is squarely within your normal IgG range (which can be found on your quantitative IgG test result). Then ask yourself if you are currently prone to getting infections or getting sick more often or not since getting your smoldering multiple myeloma diagnosis. At least that is what I would do in addition to asking my onc for his/her opinion.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Travel to Caribbean and vaccines
Thanks, Multibilly
I am IgG kappa.
In August, my M-spike was 1.4 g/dL or 1,400 mg/dL and my IgG level was 1,966 mg/dL. So my normal IgG is 566 mg/dL, just out of the bottom of the normal range given (650 mg/dL-2000 mg/dL).
IgA and IgM are normal. My absolute lymphocyte number is low end of normal.
This year, I have not been sick once. I have been around sick family members for the past few weeks and have not caught what they have.
I am IgG kappa.
In August, my M-spike was 1.4 g/dL or 1,400 mg/dL and my IgG level was 1,966 mg/dL. So my normal IgG is 566 mg/dL, just out of the bottom of the normal range given (650 mg/dL-2000 mg/dL).
IgA and IgM are normal. My absolute lymphocyte number is low end of normal.
This year, I have not been sick once. I have been around sick family members for the past few weeks and have not caught what they have.
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FingersCrossed - Name: FingersCrossed
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Oct 2014 (Smoldering)
- Age at diagnosis: 44
Re: Travel to Caribbean and vaccines
I would ask your onc what he/she thinks about this IgG level. But I think a lot of doctors hold off on IVIG treatment until a patient actually starts to experience recurrent infections - although I've read about a couple of instances on this forum where IVIG treatment has been given to patients with symptomatic multiple myeloma that are not experiencing recurrent infections, but have lower-than-normal antibody levels.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
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