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911Doctor
911Doctor, Doctor
Category: Health
Satisfied Customers: 5094
Experience:  Board Certified Emergency Physician
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doctor wants to test me for multiple myeloma

This answer was rated:

doctor wants to test me for multiple myeloma

911Doctor :

Welcome, My answers are for educational purposes only. Remember please, that we do not get paid if you do not click 'accept' / give positive ratings!

911Doctor :

What question can I answer for you about this?

Customer:

scared to death

Customer:

protein level 8.2

911Doctor :

okay

Customer:

albumin 4.3

911Doctor :

protein in the urine or the blood?

Customer:

that was on blood test

911Doctor :

what symptoms are you having that took you to the physician in the first place?


 

Customer:

mcv 72.2

Customer:

anemia

911Doctor :

so there must be more to this story than anemia and these numbers.... I'm confused as to why he/she suspects multiple myeloma.

Customer:

calcium 10.0 anion gap 4.0 protein elevated they say at 8.2 I am a 47 year old female

911Doctor :

still perplexed.... this is not a disease diagnosed based on any of the labs you have drawn, which are routine screening labs...

Customer:

I started taking iron pills and hemoglobin went from 10.2 to 11.1

Customer:

low hemoglobin low hematocrit

911Doctor :

so why does the doctor think this is not simply iron deficiency anemia?


 

Customer:

wbc 6.86 rbc 4.89 platelets 332 mcv 72.8 mch 22.7 she said the protein level was high

Customer:

ferretin 13.3 (rose from 5.0 in a week)

Customer:

also said my b12 was on low side

911Doctor :

this sounds very much to me like your doctor is simply trying to take a bad disease off the list

Customer:

could it be mm

911Doctor :

and based on the numbers you have given me and the story you tell I do not think this is a likely diagnosis at all

Customer:

protein high and calcium borderline high

911Doctor :

Sure it could be. All of us every day could have a hidden cancer, but these labs are SO non specific and SO subject to variability, the whole reason to get the more specific test is to take MM off the list, and you do not appear to have any of the typical symptoms

Customer:

and then add anemia when you look all that up it points to mm...I do have some back pain from time to time

911Doctor :

do you have a good reference on multiple myeloma so you can read in plain form what the disease is and how people who have feel?

Customer:

no...what WOULD I look for? as far as labs

911Doctor :

DON'T look at labs

911Doctor :

People get very upset over minor lab abnormalities, and I can understand you being upset at your minor abnormalities because your doctor wants to check for MM... so be it. I would pay attention to the SPECIFIC tests for multiple myeloma that will be done, a serum protein electrophoresis and a urine protein study as well.

911Doctor :

you may need Xrays

Customer:

Im sorry...what would you consider high protein?

911Doctor :

do you have a reference range printed on your lab sheet? there are different 'normals' in some labs...

Customer:

6.1-7.9

911Doctor :

6 to 8.3 is the reference range at our lab


 

911Doctor :

so your level is 8.2, slightly abnormal


what SYMPTOMS are you having?

Customer:

she did say she runs this test on all patients with anemia over 40 but with the back pain and some abnormalities in lab work it is scaring me to death....anemia and back pain occasionally (which Ive had for years) are the only ones

911Doctor :

Trustworthy and written for patients

911Doctor :

okay, fair enough

911Doctor :

but again, not something that makes me think of MM... if you have new bone pain in various locations, a protein of 12, a hematocrit of 27, and protein also in your urine then I would think of MM... but your doctor is being thorough, and that is good, though it is causing you great distress while you wait

911Doctor :

Again, these values may simply be YOUR normal

911Doctor :

Often these slightly abnormal labs are simply followed over a few months, but some doctors want an answer right away, and I think this is very reasonable as well... then you don't have to keep coming back for non-specific labs.


 

911Doctor :

are you there?


 

Customer:

sorry nothing showed for a while...I am petrified

911Doctor :

I don't know if I can help with that beyond what I have told you. I don't think you have MM but think the testing is reasonable, and now, especially, since you are thinking about it best to have the testing done and put it behind you.

Customer:

would the iron be working and bringing up my levels if it were mm.....and I do appreciate your opinion

911Doctor :

Probably not, though if you had MM AND iron deficiency anemia it might... And with your MCV being low the indications are that you DO have iron deficiency anemia and I do NOT see any red flags in these labs for MM, again, probably your doctor being very cautious.

911Doctor : Please let me know if you have further questions.
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911Doctor : Best
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