Category: Myeloma

Myeloma

Another bout of shingles

According to the NIH web site,

Shingles (herpes zoster) is an outbreak of rash or blisters on the skin that is caused by the same virus that causes chickenpox — the varicella-zoster virus. The first sign of shingles is often burning or tingling pain, or sometimes numbness or itch, in one particular location on only one side of the body. After several days or a week, a rash of fluid-filled blisters, similar to chickenpox, appears in one area on one side of the body. Shingles pain can be mild or intense. Some people have mostly itching; some feel pain from the gentlest touch or breeze. The most common location for shingles is a band, called a dermatome, spanning one side of the trunk around the waistline. Anyone who has had chickenpox is at risk for shingles. Scientists think that in the original battle with the varicella-zoster virus, some of the virus particles leave the skin blisters and move into the nervous system. When the varicella-zoster virus reactivates, the virus moves back down the long nerve fibers that extend from the sensory cell bodies to the skin. The viruses multiply, the tell-tale rash erupts, and the person now has shingles.

I’m taking Famvir for my shingles, 3 times a day, for 7 days. This outbreak has manifested itself on my right arm and hand. You’d think I would have known what it was, since I had it a few years ago. I didn’t though, and was glad I showed the doctor. I have been struggling with rashes from Velcade & Doxil, so I was inclined to ignore it. The difference was that this rash hurt. The other rashes had pretty much cleared up after I started to get decadron and benedryl in my IV with each treatment, thanks to Eric’s suggestion.

Famvir is something that’s prescribed for genital herpes, so I’m embarrassed when I go to pick my rx. Dumb as this is, I loudly ask the pharmacist if I need to take my shingles medicine with food.

There’s more on my blog about my experiences with shingles. and here:
More about shingles on this blog

Unusual lab report

I was shocked when I saw a copy of my most recent lab report. My IgA was at 1080 mg/dL! It was just 676 a few weeks ago. The m-spike a few weeks ago (3/20) was 0.7 g/dL. This time, there are two m-spikes. One is 0.44 g/dL and the other is 0.13 g/dL.

This IS from a different lab, but it’s about a 100 higher than the last test I had done through this lab.

4/3/2007

Test Result Ref. Range

IgG…….375……….694-1618
IgA…….1080……..68-378
IgM…….23…………60-263

Lab report

On Tuesday, I went to UNC with a friend. We often ride together, since we see the same doctor. I asked for a printout of may lab results, and here it is.

Test Name                Result     Flag     Units     Range
IGG, Serum               347        L        MG/DL     600-1700
IGM, Serum               <25        L        MG/DL     35-290
IGA, Serum               676        H        MG/DL     40-400
SPE Interpretation      The SPE pattern demonstrates a
single band of restricted mobility in the gamma region, which
may represent monoclonal protein.
Total Protein, SPE      7.5                 G/DL      6.6-8.0
Immunofix, Serum     Monoclonal component typed as IgA Lambda.
Concentration of monoclonal protein determined
by serum protein electrophoresis is 0.7 g/dL.
Kappa Free, Serum     <0.30      L        MG/DL     0.33-1.94
Lambda Free, Serum   1.29                MG/DL     0.57-2.63
K/L FLC Ratio             Unable to calculate the ratio due to a free light chain
concentration that is too low to accurately quantify.

After my friend’s appointment, we left, and were in the parking garage when she got a call on her cell phone from the doctor. He asked her to come back so she could be admitted. Her creatinine level had risen to 4.4 mg/dL! She has spent the last few days in the hospital at UNC, undergoing tests and receiving IV normal saline. Tomorrow is a kidney biopsy. It’s likely she’ll be able to go home on Saturday. We all hope her kidneys will recover quickly.

IgA is down again

My IgA was 676 mg/dL as reported by the lab at UNC today. That’s down almost 300 mg/dL from last month (964). It continues to move in the right direction. My doctor said that he has people who have done Velcade & Doxil who have gotten 2 year remissions from it.

Miscellaneous

I just finished watching Gallipoli, with Mel Gibson (from 1981). That movie makes me think of Chris Hollyer. Each year, on ANZAC day, he would write to the list about the meaning of the day to people in Australia and New Zealand. We’ll have to maintain the tradition for him.

If you’re interested in reading health news, and would like one place to go to get the headlines and discuss the news, try http://digged.healthblogs.org/. I’m sort of addicted to news, so I hang out there a lot now. If you know of any good RSS newsfeeds for health, let me know.

Does anyone know what the lifetime limit is for Doxil? That’s something I need to look up and stay aware of. I looked at my chart last week, and thought I saw that I’m getting 65 mg/m2. The usual dose for this regimen is 30. I need to see the doctor and make sure. I could have misread something!

Quick update

I just got off the phone with the nurse at my oncologist’s office and got some good lab results. She read off everything, but I didn’t have a pen and paper. I just remember the immunoglobulins, so here goes:

IgA 964 mg/dL
IgG 316
IgM 23

I think she said my 2 m-spikes added up to something like 0.4 g/dL. I’ll be there Tuesday to start another cycle of Velcade and Doxil, so I’ll get a copy of the report then. Last month, my IgA was in the 1300s. Before I started, it was in th 2200s. 964 is good! Maybe another cycle will get me into the normal range, which is a place I haven’t been since my diagnosis. A remission would be nice.

Last week off

I had last week off treatment, which was nice. This week I just had Zometa, which I learned from others never to have on the same day as Velcade. They reported severe flu-like symptoms, which I want to avoid! I had blood drawn today, and can call on Thursday or Friday to find out what my m-spike and IgA are. We’re expecting it to be lower than last time. I haven’t had the standard 21 day cycles of Velcade and Doxil. My doctor is doing it in 28 day cycles. I don’t mind. I only hope it’s as effective. The hives I got after the last injection are still here, so I’m going to take Eric’s advice and have IV benedryl and decadron next time. That’ll be Tuesday.