Thursday, November 15, 2007

So What's That Funny Looking Jug In the Fridge?

Well, there's a first time for everything!

First, the good news. I saw the hemotologist oncologist for the first time yesterday and she, as the expert, says she thinks it's highly unlikely that I have multiple myeloma. She says the level of monoclonal proteins in my blood is relatively low and that she would expect to see other issues popping up in my complete blood count if I really had cancer.

Just to be sure, she is running some blood tests that are more sensitive than the ones I have already had. She's also having me do a 24-hour urine collection that they'll do the same electrophoresis on as they did on my blood to see if the monoclonal cells are in my urine too.

That explains the funny orange jug in our refrigerator! (Ellie found it very entertaining to watch me pee into the white collection bowl and then pour the urine into the orange jug. I then showed her the level of urine that you could see through the side of the jug and told her, "See, that's all the pee-pee Mommy made today!"

Meanwhile, I went to the hospital today for a "metastatic skeletal survey," which essentially was 15 to 20 x-rays of me from head to toe lying on my back and then again on my profile. I and most people I told about it were surprised that it was a series of x-rays and not a bone scan, MRI or CT scan.

Here's an explanation I found on the Web:

Bone scan is more sensitive than skeletal x-rays in detecting bone metastases and in assessing the overall extent of disease except in multiple myeloma, renal cell carcinoma, and thyroid cancer where many lesions are purely lytic without the new bone regeneration detected by bone scans. A bone scan (or skeletal survey in myeloma) should be performed when pain suggests metastatic disease. Bone scans do not provide detail of the structural lesion in the bone; for this reason, x-rays should be obtained of abnormal areas of tracer accumulation detected on the bone scan. In particular, painful areas and those in weight-bearing bones should be x-rayed.

Anyways, apparently they have their reasons for sticking to x-rays when checking for myeloma.

If all the tests come back looking good, Dr. Simic says I won't have to undergo a bone marrow biopsy. While I'm certainly willing to do it if that's what it takes to be sure I don't have cancer, I'm very happy at the prospect of missing out on that joyful experience. She said she would try to call me with test results next Tuesday.

So, while I would very, very much like to get a diagnosis so we can start treating this illness with more than narcotic painkillers, multiple myeloma definitely isn't a diagnosis I would mind missing out on.

Once I'm cleared of the cancer threat, I assume I go back to my internist, who said she'd be willing to try me out on Plaquenil, a immunosuppressant that is used to treat Lupus. If we don't see any improvement after I'm on Plaquenil, I'm not sure where we go from there. I guess fibromyalgia and chronic fatigue syndrome are possibilities ... but I'm going to try not to worry that far ahead of myself.

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