Category: Myeloma Treatment

Myeloma Treatment

Latest electrophoresis, proteins and free light chains

Here are my latest results.

Specific Proteins

Test Name    Result       AB    Normal Range   Units
IGG          466          L     600-1700       MG/DL
IGM          31           L     35-290         MG/DL
IGA          408          H     40-400         MG/DL

Electrophoresis

The SPE pattern demonstrates two bands of restricted mobility in the gamma region.

Immunofix, Serum

Monoclonal component typed as IgA Lambda. Concentration of monoclonal protein determined by serum protein electrophoresis is 0.4 g/dL.
Monoclonal component typed as IgA Lambda. Concentration of monoclonal protein determined by serum protein electrophoresis is 0.3 g/dL.
*Suggestive of a monoclonal component typed as IgG Kappa. Concentration of monoclonal protein is too low to accurately quantify.

* This is new! Previously, I’ve only ever had just two m-spikes. That’s not enough?  I vaguely remember seeing this on one other report, so maybe it’s something that comes and goes.  In any case, it’s not enough to measure, so I’m not alarmed.

Serum Free Light Chain Assay

Test Name                  Result     AB  Normal Range    Units
Kappa Free, Serum          0.1380     L   0.33-1.94       mg/dL
Lambda Free, Serum         1.24           0.57-2.63       mg/dL
K/L FLC Ratio              0.1113     L   0.26-1.65       mg/dL

Still, no myeloma treatment for over two years.

MRIs and Mutliple Myeloma and gadolinium, oh my!

Margaret’s blog has a few posts written about the use of gadolinium as a contrast agent.  I think it’s important for MM patients to know about this.  You can the read posts at her blog.  These are all the posts containing the word, “gadolinium.”
»The gadolinium used in MRIs makes myeloma cells proliferate

In other news, there’s not much going on.  Last week I got to participate in a local radio show with two of Moore County’s finest, Detective Sgt Donnie Shingleton and Sgt Tim Cameron, of the Moore County Sheriff’s Department.  The topic was home security, which included discussions about fraud.  My part was Internet fraud.  My words didn’t really come out right!

Ticket to Ride by Ed GormanI start a creative non-fiction class tomorrow, thanks to my sister, Rachel.  She’s encouraged me to git me some more learnin’ so’s I kin write better.

Monica and I are taping for another radio program this morning.  I’ll let you know how that one turns out.

How many of you bought Ed Gorman’s new book? If you haven’t gotten it yet, now’s a good time.  » Ticket to Ride by Ed Gorman.   He wrote something to me on the dedication page!

Dr. Brian Durie to host a teleconference

Dr. Brian Durie, Chairman and Medical Director of the International Myeloma Foundation, will host a teleconference next week to highlight key myeloma presentations at the upcoming American Society of Hematology Annual Meeting. The teleconference will take place on Monday, November 30th at 11 a.m. ET.

Discussion topics will include:
§ Treating the full cycle of myeloma
§ Pipeline drugs – what’s next and why they’re needed
§ Genetic variations in survival and outcome

Here are the dial-in details for the teleconference:

800.860.2442 (U.S.) or 412.858.4600 (outside of the U.S.)
Pass code: IMF

Myeloma treatment drug maker Celgene flagged for a buy

Probably most of us who’ve had treatment for our myeloma have been prescribed one of the drugs manufactured by Celgene.   Celgene makes Revlimid® (lenalidomide) and Thalomid® (thalidomide).

That really annoying guy on TV, Jim Cramer (Mad Money, CNBC), says it’s on his list of stuff to buy.   According to the CNBC site:

So when do you buy CELG? Cramer said that investors could wait until the annual American Society of Hematology (ASH) meeting on Dec. 5, where Celgene is expected to present “some terrific Revlimid data.”

“I wouldn’t pull the trigger on this trade until the week before the conference,” Cramer said.

http://www.cnbc.com/id/33603726

I’ll be waiting to see what happens during the ASH conference.

If you’re sick, please stay home!

The last few appointments I’ve had at the Bone Marrow Transplant Clinic, I’ve had to wear a mask into the facility.  Everyone has always had to wash their hands before entering, but the masks are a new thing.  It’s meant to protect the patients whose immune systems have been wiped out or weakened by high dose chemo.  A few days ago when I was there, I saw a woman walk up to the desk to check in and heard her say, “I think I might have the flu.”  They whisked her off to an exam room so she wouldn’t be putting others at risk.  The first thing I wondered was why didn’t she call ahead and ask if she should show up for her appointment?  She could have rescheduled.  I noticed that they sanitized the desk top after she was gone, and I imagine they probably had to do the same with the exam room.

It seems like the flu (seasonal and H1N1) is getting all the attention lately.  Have a look at this article to take your mind off of it all: Don’t Be a Statistic

Myeloma Treatment

Message from Pat & Pattie Killingsworth

Hi Beth-
I attended IMF conference in Twin Cities last weekend. Some interesting opinions and exciting news about maintenance therapy with or without a transplant. Go to www.multiplemyelomablog.com and follow my reports. How are you feeling? Hope all is well- Pat

Pat & Pattie Killingsworth
Pat@HelpWithCancer.Org
St Croix Falls, Wisconsin
Toll-Free 866-336-1696

Big Medical Bills

My nephew called last night to tell me that he’d had a trip to the ER Monday from work, by ambulance. He became really dizzy, and wasn’t even able to walk.  His manager called for an ambulance, and he was taken to the nearest hospital.  The ride made him feel even worse, causing nausea and vomiting.  After several hours at the hospital, he was told he had vertigo and was allowed to go home.  He saw a doctor the next day to make sure there wasn’t anything more he needed to do.

One of his concerns was the bill.  As someone who’s been paying medical bills on a continuous basis for over 6 years now, I offered some advice.  My advice to anyone who incurs hefty medical bills is to negotiate payments if you’re not able to pay the whole thing at once.  I’ve never been turned down by any hospital for a payment schedule, and they have never charged interest. Whatever you do, don’t put the charges on a credit card.

I do have pretty good insurance, but the annual out of pocket expense is up to $3500, depending on how much treatment I have, how many doctor appointments there are, what medications I’m on and if there were any hospital stays. In addition to the maximum out of pocket expense ($3500), there are drug and doctor copays.  There are also parking fees and driving expenses.  It can add up to a lot, believe me.  If I’ve made a trip to the Mayo Clinic or Dana-Farber or someplace, there are even more expenses.

I’m lucky that I have insurance that’ll cover the major stuff. Our plan has no lifetime maximum, and we have good prescription coverage. I don’t think anything I’ve ever done has been challenged by them.  I can see specialists when I want to, and only the really big stuff, like the stem cell transplant, has to be pre-approved.

There’s one problem with my insurance.  It’s tied to my job.  Should anything ever happen to cause me to lose my job, I’d be in big trouble.  I’m not old enough to be covered by Medicare and not poor enough to be covered by Medicaid.  I’m not elligible for disability, either. I’m an insured middle class person who, like most other working Americans, could easily become uninsured.  It’s a situation that can cause worry, because there’s nothing much I could do, except for exhaust my savings and sell my belongings to raise money for treatment if it was needed if, for any reason, I were to find myself uninsured.

I believe we do need to find a solution to address the need for affordale health care for all Americans.  I don’t think it’s something that we can keep putting off.  The way things are now, the very poor and the elderly get decent health care, and the middle class is left to fend for itself.  If employers provide group plans, that’s great, but there are a lot of people who have to pay for their own insurance or have none at all.  If you have insurance through your employer and lost your job, how long could you afford to pay the premiums?

I would ask that the people who think we should ignore the problem a while longer try to imagine yourselves jobless and without health care coverage. Then imagine that you have a chronic health condition or serious illness or injury. How will you manage to pay for your treatment or care?  What if you can’t even get insurance because of a pre-existing condition?

I usually don’t write about politics, but health care is a hot button issue here. I can’t imagine how any human being can want to deny another person the right to decent, affordable health care. Any of us could find ourselves in need one day.

Balloon Kyphoplasty for Spinal Compression Fracture

I got this alert last night, and it may apply to myeloma patients who have had spinal compression fractures.

Balloon Kyphoplasty for Spinal Compression Fracture

At 1 month, kyphoplasty patients had significantly greater improvements in global quality of life, back pain, and function than did controls.

In vertebroplasty and kyphoplasty, two minimally invasive procedures for spinal compression fractures, cement is injected into damaged vertebrae to prevent further compression and to alleviate pain. In kyphoplasty, a balloon is inflated within the vertebra to restore normal height and shape, and cement is injected into the resulting cavity. Although both procedures have been in use for longer than a decade, few data support long-term safety and efficacy of either one. With funding from a kyphoplasty instrument manufacturer, researchers randomized 300 patients with one to three acute vertebral compression fractures (average duration, 6 weeks) to receive supportive care alone or supportive care plus balloon-assisted kyphoplasty.

When the groups were compared after 1 month of follow-up, kyphoplasty patients had significantly greater improvements in global quality of life, back pain, and function and reported significantly fewer days of restricted activity. During the next year, these differences between groups narrowed, with some (but not all) losing statistical significance. Adverse events were similar in the two groups, apart from two reversible perioperative complications and a nonsignificant trend toward more new vertebral fractures in the kyphoplasty group.

Comment: This nonblinded study provides additional evidence that kyphoplasty improves symptoms and function more rapidly than supportive management. Although short-term pain relief and earlier resumption of normal activities are important outcomes, more data on the long-term efficacy and safety of the procedure are needed. The authors of the current trial will collect another year of follow-up data, and other groups are conducting randomized studies to compare vertebroplasty to kyphoplasty or to sham procedures.

— Bruce Soloway, MD

Published in Journal Watch General Medicine April 7, 2009

Citations:
Wardlaw D et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): A randomised controlled trial. Lancet 2009 Mar 21; 373:1016. [Medline® Abstract]

Kallmes DF and Jarvik JG. Spinal augmentation research: FREE at last? Lancet 2009 Mar 21; 373:982. [Medline® Abstract]

Copyright © 2009. Massachusetts Medical Society. All rights reserved.

The above message comes from “Journal Watch”, who is solely responsible for its content.