Friday, October 26, 2007

A Wrench In the Works

Ok, this is pretty much a repeat for anyone on my email list -- and I suspect that's all who is reading here -- but just in case someone found me by serendipity and has been wondering about the test results, well, here it is.

I had a bit of a surprise a couple days ago when my rheumatologist called me to say that some test results suggested there could be a problem with my bone marrow. He referred me back to my internist with the suggestion that I be sent to a hemotologist for a bone marrow biopsy.

The first blood test was a serum protein electrophoresis, which is used to identify at least two dozen diseases including lupus and RA, and it came back with just a borderline irregularity and the recommendation that it be followed up with an IFE (which I'm not entirely sure what it stands for ... immunofixation something, I believe).

That test confirmed the presence of monoclonal immunoglobulin in my blood, which can be a sign of a bone marrow issue.

I followed up today with my internist, who says that while it's not likely that I have cancer, it's important to rule it out before we go any farther. Specifically, the form of cancer they'll be looking for is multiple myeloma.

She remains convinced, however, that my problem is an autoimmune disease. I asked about starting on plaquenil now just to see if it helps, and she said we had to wait until the bone marrow problem is ruled out because if I do have an issue, it could be a really really bad thing to be on immunosuppressants.

But the fact that my joint pain has spread to the knuckles on my fingers in the past few weeks really just increased her certainty that I've got an autoimmune problem.

I have an appointment with a hemotologist oncologist on Nov. 7. I don't expect her to express any opinions then, just do a patient history and probably repeat the bloodwork that the rheumatologist did to see if it was a fluke.

If I still have the monoclonal immunoglobulin in my blood, she'll most likely order a bone marrow biopsy, and then we'll finally be able to rule out a problem there.

The downside is that my internist says that while it's possible to have these monoclonal immunoglobulin thingies in your blood and not have cancer, it's usually a sign that you're likely to develop it later as you age. Which wasn't exactly what I wanted to hear since I'm pinning my hopes on not having cancer.

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