Sunday, January 16, 2011

Itty Bitty Snowstorm

We three headed off to Rochester for my every-28-day early-morning blood draw at Mayo Clinic, part of the Phase II pomalidomide study. Highway 52 was dry and clear of ice, until suddenly we found ourselves in a snow squall at 65 mph. Traffic slowed, the road was wet, the flying snow swirled in our headlights. Then, in less than a minute, the snow disappeared again, giving way to a clear, starry sky. Why? During that little storm we passed by a refinery, and apparently the zero-degree air was turning the refinery's abundant water vapor exhausts into a local micro-mess for travelers. I've never seen that before. I don't mind if I never see it again.

Cancer Markers:

The Mayo visit went OK, the end of the 37th 28-day cycle. After a 6:30 am blood draw I was scheduled for a 3:15 pm visit with Dr L, but got in to see Dr KDS (yes, she's still here!) instead at about 10:15, which got us home hours ahead of the original schedule.

Test results, however, were no better than so-so. IgG went up about 8%, from 1080 to 1170 mg/dL, and M-spike skyrocketed 20% from 1.0 to 1.2 g/dL. Converting units, this puts M-spike at 1200 mg/dL, which is a physical impossibility because M-spike is the monoclonal (bad) part of IgG and therefore must always be lower than IgG. So which measurement is wrong? I'm of the opinion that IgG, measured by immunofixation, is more accurate than M-spike, measured by electrophoresis, so I'll take that IgG value. In fact, I think that Mayo's M-spike measurements have always been high. When I changed from Minnesota Oncology to Mayo three years ago, my M-spike jumped up 32% even though IgG sat still. I don't know which is wrong, MOHPA or Mayo, but there is certainly something fishy today. Anyway the cancer markers are up a little, but they do bounce around, and I don't need to get my shorts in a twist about it.

Calcium and Creatinine:

Dr KDS is just a little concerned about calcium at 10.3 mg/dL and creatinine at 1.4 mg/dL, both slightly above the reference range. Calcium has been that high before, but creatinine, which is a measure of kidney function (malfunction?), has never been quite so high. She gave me an order to have those tested again in a week, at the local clinic. She couldn't think of a medical reason why BOTH calcium and creatinine would go high at the same time. Vitamin K2 helps calcium to deposit in the bones instead of circulating in the blood, and I had been out of it for a couple of weeks, so I'll take that for the calcium and lots of water for the creatinine and see if those numbers go down.


Pomalidomide drives neutrophils down, including mine. If they go below 1000 cells per microliter, I have to go off the study, at least until they come back up. As in recent months, I had neutrophils checked (CBC with Diff) the day before the Mayo visit, in the afternoon at the local clinic, instead of in the morning at Mayo when all of the other blood tests are done. At 1:00 pm on Wednesday, neutrophils measured 1800, well above the threshhold and actually into the "normal" range. Unknown to me, though, Mayo had accidentally scheduled another CBC, to be done with the other tests at 6:30 am Thursday. Since it was the more recent test, it would override the previous test if it were under 1000. Happily, it was 1190. Note, though, that the afternoon neutrophil count was 51% higher than the morning count. I also do some vigorous exercises just before the blood draw, because adrenaline helps too. These are not tricks - the neutrophils are real - they just hide in the morning. It doesn't work for everyone, I'm told, but it's working for me.

Some Current Test Results:

Test    Oct 20    Nov 18    Dec 16    Jan 13     Remarks
M-spike g/dL 1.1 1.2 1.0 1.2 Best tumor measure?
IgG mg/dL 1130 1300 1080 1170 Best tumor measure?
L FLC mg/dL 2.78 2.92 2.41 2.49 L Free light chains
Calcium mg/dL 10.0 10.3 9.8 10.3 Slightly high
Creatinine mg/dL 1.0 0.9 1.0 1.4 Kidney, high
HGB g/dL 14.9 15.0 14.6 15.3 Hemoglobin, OK
RBC M/uL 4.31 4.26 4.23 4.48 Red cells, marginal
WBC K/uL 4.3 5.9 5.1 3.3 White cells, OK
ANC K/uL 2.14 2.30 2.50 1.19 Neutrophils, sufficient

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.

Recent breakfast, oatmeal on top. Frozen organic blueberries and strawberries, fresh kiwi, organic walnuts, organic kefir (tastes better than yogurt):


  1. I've noticed my M-spike is always a little higher at Mayo, too. I think you're on to something!

  2. Hi Don,

    My name is Natalia, I am the Community Coordinator at WEGO Health - an online health community meant for people like you who are especially active online around different health topics. We call these people Health Activists and our mission is to empower them to help educate and support their own online communities.

    I have been researching Multiple Myeloma lately and came across your blog. I think you are a wonderful writer. I especially liked the "99 Things about Me" post!

    I decided to feature your blog on WEGO Health in my "11 Multiple Myeloma Blogs You and Your Members Should be Reading" blog post;

    I hope that you check it out! I would love to hear your thoughts on other blogs to add to the list. It would also be wonderful if you could share it with your community on your blog.

    Anyways it has been lovely reading your blog, I hope all is well and to hear from you soon!

    All my Best,

    Natalia Forsyth
    Community Coordinator
    WEGO Health
    180 Lincoln Street, 5th Floor
    Boston, MA 02111
    mobile: 617 777 4271 (note: this is my only phone)
    fax: 617 426 5027
    empowering health activists to help others

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  3. Thank you Natalia.

    Update: Both calcium and creatinine were back down to normal values one week after the Mayo visit.

  4. A bit like different weight scales! A lot can happen between the draw, the journey to the lab, the lab, the equipment, the report. ARGH! Just another thing we have to scrutinize!

    Hang in! Always checking on you...