More Than You Want to Know

Three different medical tests in the last two days:

• MRI of Lower Spine: Examine the nerves in the lower spine to address the neuropathy (falling asleep feeling) that occurs only in the right leg. Thalidomide can cause neuropathy, but it is usually symmetrical.


• CT Scan of Skull: Learn more about the "lucent lesions" (representing small dense places) reported on the recent x-ray bone survey. These can be caused by myeloma, or maybe I just wandered too close to the Vice President and his shotgun.


• Bone Marrow Biopsy: This is the gold-standard measurement of the progress of myeloma, the actual tumor burden. A sample of bone marrow and a separate sample of the bone itself are extracted from the hip. It is an outpatient hospital procedure, with normal life resuming within a day or two afterward.

Plasma cells are an important part of the human immune system, producing the immunoglobulins that fight infection and disease. Myeloma is a proliferation of malignant plasma cells.

Two important results from the bone marrow biopsy are the percentage of plasma cells in the blood and the percentage that are abnormal. Normally those are about 2% and 0%. I have had two prior BMB's; last time my numbers were about 9% and 1.5%. When myeloma is at its worst, both numbers can be as high as 80% or 90%. Some doctors say that 10% is the threshhold for Stage 1 myeloma, others say 20%. So far, my myeloma has been below Stage 1, not yet hurting any bones or organs.

The BMB also returns many other results, some of which can be predictive of the aggressiveness of the disease, the speed with which the cancer is apt to grow. Those results have previously shown that my myeloma was only moving at a modest pace. Let's hope these do too. I'll post about it.

Love those people who are close to you, and make today a masterpiece!