Thursday, November 15, 2012

61 Cycles and Still on Pomalidomide

Thursday, November 15, 2012:

IgG has been edging up slightly over the past few months. It dropped slightly last month, but this month continued the slow upward climb, from 1180 last month to 1270 mg/dL now. More significantly, M-spike jumped from 1.0 to 1.2 g/dL. Those are separate but related markers which can indicate the total tumor burden, the number of myeloma cells. Down is good, up is bad. HOWEVER, both IgG and M-spike have been this high before, and none of the other markers suggests a problem, so there is no reason to think seriously about alternative treatments yet. Pomalidomide has worked like magic for the past four and a half years, and most likely is continuing to work.

Dinner after Mayo visit.
All organic but the kiwi.
In discussion with Dr L, we noticed that my IgA has moved up into the reference range for the first time since my myeloma was diagnosed nine years ago, almost tripling from 33 mg/dL last month to 86 this month. She asked if I had been sick in the last month, and I said that I did fight off a cold, ending just this week. She replied that the immunoglobulins like IgA and IgG can bump upward when fighting off an infection, and the effect can last up to six weeks. Even M-spike can go up, though it isn't really a competent immunoglobulin. So I'm thinking that any increase in IgG or M-spike can probably be attributed to that cold, and my myeloma is still stable.

That's my story and I'm sticking to it, at least for another month.

Two other issues discussed with Dr L:

1. A recent news report connected a genetic mutation in the white cells with Alzheimers disease. Since myeloma is also a genetic mutation in white cells, I wondered if there was a connection between myeloma and Alzheimers. She said there was not, and in fact the amyloids that collect in an Alzheimers brain are not the same as the amyloids most commonly produced by myeloma.
2. One of our support group members had mentioned that his myeloma was actually first diagnosed by his opthalmologist, and I asked how that works. She said that advanced myeloma can result in a collection of (proteins?) that the opthalmologist can actually see inside the eye. Several of her patients were initially diagnosed by eye doctors.

Hawaii: My family and I have run a marathon in each of 49 states now. The remaining state is Hawaii, and we are registered for a marathon in Hololulu soon. Airline tickets are purchased, hotel reserved, we're fixin' to finish it up! Then what? We have already registered for one marathon in 2013, so plans are forming but not solid yet.

Most-Recent Test Results:

Test    Aug 23    Sep 20    Oct 17    Nov 15     Remarks
M-spike g/dL 1.0 1.0 1.0 1.2 \ Tumor marker up 20%
IgG mg/dL 1180 1210 1180 1270 / Tumor marker up 8%
Lambda mg/dL 2.72 2.61 2.38 2.92 L free light chains
Calcium mg/dL 9.6 9.7 10.0 9.6 OK
Creatinine mg/dL 1.0 1.1 1.3 1.2 Kidney, OK
HGB g/dL 14.5 15.1 15.7 14.7 Hemoglobin, OK
RBC M/uL 4.09 4.22 4.35 4.13 Red cells, a little low
WBC K/uL 4.3 3.7 4.4 5.5 White cells, fine
ANC K/uL 1.90 1.70 1.90 3.0 Neutrophils, wowzer

Related Links:

My Myeloma     A discussion of my myeloma, not very technical.
My Treatment History Not technical.
My Test Charts Graphic displays of several key test results over time.
My Test Result Table Somewhat technical. Best with a wide browser window.
My Supplement Regimen With links to where I buy them.

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