M-spike not increased from prior electrophoreses

The last few months, I haven’t had a measurable m-spike, but I still have an elevated serum IgA (1177 mg/dL this month – usually in the 900s). My doctor is going to have me start the freelight test, starting next month. Here’s what he said about this month’s test:

“The SPEP was read as showing a monoclonal protein, but it overlapped other normal proteins in the beta region and they could not get an accurate densitometry done to come up with a number value. This is not at all unusual for patients with an IgA myeloma, unfortunately. I did look at it and visually the amount did not seem large, and also was not increased to my eye from prior electrophoreses. It might be helpful in the future for us to follow your disease with a serum free light chain assay. I will have that done next time, though for this time it is unfortunately too late.”

BTW, I had been taking just dex 2 days a week. 40 mg on Friday and 20 on Saturday. The longer I’m on dex, the less I can tolerate it, so last month I went to just 40 mg a week. That explains the increase in IgA. My IgA has been in the 900s for about a year now. It had been a little lower (800’s a few times & 700s once) when I was still taking thalidomide. I’m going to go back to the twice a week thing. Does anyone have ideas for any other dosing schedules? Would it be easier to split up the doses and not take them on consecutive days?

Also, I do have high blood sugar when I take dex. Not high enough to treat, according to my endo, but can get up to 200 on dex days if I’m not careful!