In my February column ^[1], I shared my con­cern that my upcoming three-month checkup could reveal that I relapsed. This was due to the fact that the blood test results at my checkup in December showed a faint-to-moderate sign of a monoclonal protein – the first time this had happened since my autologous stem cell transplant in early June of 2014.

I consider myself an optimistic individual. But in the days leading up to my three-month checkups, a pessimistic side of me surfaces as I worry that something new will be seen in the routine tests that are conducted. I worry even though I received bad news on only two of the 12 checkups.

So it goes without saying that I was particularly anxious as my checkup appointment approached last week.

The routine of such appointments over the last four years hasn't changed. Check in, register, check the vitals, answer the usual questions from a nurse – Have you fallen recently? Are you experiencing fatigue? Do you have any pain? On a scale from 1 to 10, where would you rate the pain? Any other issues? Then, have blood drawn, and wait for the doctor.

By the time I see my doctor, some of those test results are already available. My doctor has always been able to refer to the complete blood count, which provides important information about the different blood cells. He also has access to the comprehensive metabolic panel, which measures blood sugar levels, electrolyte and fluid balance, and kidney and liver function.

As has been the case in every checkup, the results of these two tests were all within the normal range, except for low potassium levels. This was somewhat surprising, since I had been taking 10 mEq of potassium a day since early December. My doctor doubled the dose to address that issue.

Most of the discussion with my doctor centered around the significance of the above-mentioned test results from December. He very patiently explained the different options that could be pursued if, as he said, my myeloma was "waking up." I thought that “waking up” was an excellent descriptive phrase of relapse and one that I had not heard before.

He explained that, because the protein detected was at such a low level, it very easily could be a lab error. He discussed a possible watch-and-wait approach, adding dexamethasone ^[2] or another drug (or two) to my current Revlimid ^[3] (lenalidomide) regimen. He made it very clear that if the worst case scenario (relapse) did occur, there was no need to rush into a new course of action. I assume this is because the results of my other regular tests have consistently shown that my myeloma is not affecting my organs or causing other health problems.

As has been the case after every checkup, I left my appointment feeling good about my myeloma future.

That optimism was short lived as my light chain test results, which were posted two days later, showed that my kappa light chains rose almost 60 percent and are now above normal. The lambda light chains and the kappa/lambda ratio also both rose, but are still in the normal range.  These results made the wait for the serum immunofixation, which detects whether there is any monoclonal protein present, almost excruciating.

Two days later, on a Sunday evening, I received an email from my doctor at 10:45 p.m., informing me that my serum immunofixation was back to normal again and that my myeloma was not waking up yet. The fact that he communicated with me late on a Sunday evening is probably an indication that he sensed my anxiety about my condition. It also demonstrates how fortunate I am to have such a caring doctor.

In my email response back to my doctor that night I asked him what the rise in my light chain levels meant.  By 8:00 a.m. the next morning, I had received a response back explaining that ratio is the more important factor to look at; even though the ratio had increased slightly, it was still well within the normal range. My doctor added that the increase in light chains was a normal fluctuation and nothing to worry about.

In other words: my myeloma is still sleeping.

What have I learned from this experience?  In hindsight, I could have spared myself a lot anxiety by taking the time in the previous four years since diagnosis to better understand what the free light chain test results indicate. I have never felt rushed or slighted for time at my three-month checkups, as my doctor and his staff go to great lengths to answer every question I have about this disease.

I always told my students or players that there is no such thing as a stupid question, and that asking questions is not a sign of ignorance, but instead an indication of trying to improve oneself.

Moving forward, I have to make sure I follow my own advice and ask the questions that will make me a better informed patient.