Thursday, August 23, 2007

New Blog

I'm thinking about building my own computer, and have created a new blog about it here.

Friday, August 17, 2007

C.R.A.B.

I have "smoldering" myeloma (or just MGUS, depending how you look at it), which means my myeloma is not symptomatic. No broken bones, kidney failure, nothing. I even ran four marathons this year, so far.

But my numbers (IgG, M-Spike, Light Chains) keep climbing, so I walk around with my fingers crossed, hoping to continue smoldering but nervously looking for that first little flame somewhere.

Enter the CRAB criteria: Calcium, Renal (creatinine), Anemia (hemoglobin), and Bone lesions. A person is considered to have active myeloma ("end" organ damage) when any of these criteria are out of whack.

Mine seem to be well within whack, except for the first, calcium. In the last three lab tests, calcium has edged toward the high limit of normal according to that lab. So I checked the internet to see what is abnormal according to the CRAB criteria.

The first place I looked was the International Myeloma Foundation's page about CRAB. That got me more confused. So I called the hot line and Nancy Baxter called right back. Then we were both confused, so she put me on hold and called Dr. Durie! Good job, Nancy.

If I got it right, this is what he told her:
  • Normal calcium readings are right around 9 or 10 mg/dL (milligrams per deciliter), not mg/L (milligrams per liter) as is suggested in Table 1 of the IMF page about CRAB. One mystery solved, something for IMF to fix on their web page.
  • Perhaps the best CRAB limit for calcium is the local lab's own limit. Over that you've met one of the CRAB criteria.
  • However, calcium is not usually the first criteria of the four to be met; one of the others pops up first.
The implication of all of this is that I shouldn't be too worried yet, because my calcium is still (barely) below the limit. It could easily go down again, too, because it clearly does bounce around a bit. But I will be watching.

Here is a chart of my serum calcium since diagnosis. Looks like it's creeping up in the last six months:

Serum Calcium, click to enlarge, BACK to return here

Tuesday, August 14, 2007

Life Detour

Friday night a storm blew through here and took down trees. Lots of big trees, in the yard and in our little woods. I've been working on the cleanup since.

Much more on: Storm damage

Friday, August 10, 2007

Electrolytes OK

About a week ago I had blood drawn for lab tests. They took two different vials, an unusually low number. But today when I called, the nurse said that all the doctor had ordered was "electrolytes." When I asked what that was, she said "sodium, potassium," and such. Huh. Everything was normal, said she.

I wonder why we even did the labs. Are we really concerned about sodium? Clearly, there's something here that I don't understand.

I'm still taking curcumin, 8000 mg per day, and I think that the doctor wanted to be sure that curcumin in such high doses did not throw other things out of whack. If so, he probably did his normal chemistry panel, which includes sodium and potassium, but (more importantly?) renal and liver markers such as creatinine and albumin. If so, I want to see those numbers, normal or not! She's mailing the report.

I do wonder what the second vial of blood was for, and hope that it was for a different test, like maybe the SPEP, and that she mails that one too! Doctors offices. Sigh.

More when the reports arrive.


Two lunches and a dinner plate: Lamb rollup (giro)
Organic whole spelt rollup, leftover roast local no-hormone no-antibiotic lamb, organic romaine, Sunshine sauce (organic yogurt, minced cucumber, organic lemon rind, minced garlic, dill), very ripe nectarine. Estimated Weight Watcher points = 6.

Chicken bratwurst sandwich
Chicken bratwurst, whole wheat bread, organic pickle relish, watermelon, kiwi, organic nectarine, papaya. Estimated Weight Watcher points = 7.

Salmon dinner
Wild caught Alaskan salmon, organic yogurt, spices, peas, beans, slivered almonds, dried cranberries, homemade sweet potato salad. Estimated Weight Watcher points = 9.

Wednesday, August 1, 2007

Tooth or Consequences

Myeloma can cause bone damage, which may be treated with bisphosphonates like Zometa and Aredia. Those strong medicines can, however, cause other bone problems, particularly a complication called osteonecrosis of the jaw (ONJ). With ONJ the jaw bone loses its blood supply and dies. It is painful and disabling, and to be avoided if possible!

ONJ is especially likely to occur if dental surgery is done while taking the bisphosphonate. I am not taking a bisphosphonate yet, but I did have a tooth which, though it wasn't painful, showed weakened roots on x-rays. This afternoon I had that tooth removed, so that I wouldn't need to have it done at some later date when I may be taking a bisphosphonate. As it turned out the tooth was abscessed, so it's a good thing I had it done now for that reason as well.

The curcumin regimen is going well - I have not missed a dose since I started in late June. Blood draw tomorrow, so I will know in a week if the curcumin is helping.

Potluck dinner in Minnesota last Sunday: Potluck dinner
At this particular potluck dinner, good choices were possible.

Big breakfast after an early workout:
Big breakfast
Organic oatmeal, organic fat-free milk, organic strawberries, blueberries, organic plum, kiwi, crunchy almond butter, organic rainier cherry. Estimated Weight Watchers points = 6. Good recovery breakfast - it took 16 minutes to eat it.

Salad before supper:
Luscious salad
Salad greens (organic romaine, fennel, fresh tarragon, organic fresh basil), avocado, mango, pineapple, organic strawberry, blue cheese, raspberry vinegar. Estimated Weight Watcher points = 4.

Tasty chicken supper:
Yummy chicken dinner
Grilled chicken marinated in orange juice and tarragon, pan-braised asparagus with rosemary, baked organic sweet potato slices, organic catsup. Estimated Weight Watcher points = 6.