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Veela,
I am IGG Lambda and my most recent freelite numbers were: Kappa 1.88 (low) and Lambda 99.2 (high) for a ratio of .0190 (low). I will have followup visits every six months now. I believe CMP is a blood workup (complete metabolic panel)? Is that correct, Hallie?
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Sorry, I missed that question. CMP stands for "comprehensive metabolic panel." so Iowagal, you pretty much had it! It's a suite of 14 tests:
* Glucose
* Calcium
* Albumin
* Total Protein
* Sodium
* Potassium
* CO2 (carbon dioxide, bicarbonate)
* Chloride
* BUN (blood urea nitrogen)
* Creatinine
* ALP (alkaline phosphatase)
* ALT (alanine amino transferase, also called SGPT)
* AST (aspartate amino transferase, also called SGOT)
* Bilirubin
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This is what i saw in Bone marrow byposy report :
Monoclonal Gammopathy , free lambda light chain , IgG
Interpretation : k/l ratio is approx 1, minute lamda clonal population can not be entirely ruled out.
Based on above , iam assuming IgG lambda. Even 1st free lite test shows " Kappa elevated 26.30, but lamda within range".
Current test , Kappa still same , lamda reduced to 1 point ". This surprised me.
Could it be typo ?
In addtion to IgG : IgA - also elevated , as per some other lab standards this value is out of range.
Does it mean polyclonial gammopathy and related to some hidden inflamatory disease ?
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I'm thinking a typo is possible. To solve the issue you can ask your lab or your doctor for a copy of your last immunofixation and electrophoresis results. As for the IgA, you have to go by what your lab shows as the normal range for their test. Or didn't they show their range?
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It does show range for IgA as 81-463 mg /dl and mine reported as 419. Why does each lab standards are different ? Iam using Quest for testing and each time i get different ranges. Last time it shows 70-400 mg/dl and my value was 379.
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The takeaway from this is that both times your lab considered the IgA as being in the normal range. That's a good thing! What can I say? The lab tests are constantly being refined and changing, little bit by little bit. And every time they make a small change, they have to re-establish the normal range.
Well, folks, the results of my cardioechogram came today, and I have left ventricular diastolic dysfunction, grade II. It is something that can go either with scleroderma causing myocardial fibrosis, or with MGUS causing amyloidosis of the heart muscle. So with both MGUS and the sky-high anticentromere antibodies (associated with limited scleroderma) against me I guess it was inevitable. Anyway, it explains why I've been huffing and puffing on those short walks with Hubby.
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Are there any meds that can help with that, Hallie?
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The scleroderma doc says, "No treatment yet." I think sometimes they use calcium channel blockers, but probably can't for me at this point because my systemic blood pressure is low. I've sent a copy of the report to my primary asking if he wants to refer me to a cardiologist. I just ordered a treadmill for Christmas for Hubby and me, and I think I'm going to need to know what my target exercise pulse rate should be.
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Hi, Hallie
So sorry to hear about the test results. I would think you'd be referred to a cardiologist- did you ask to have that test or did one of your drs. order it?
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Hallie,,
sorry to hear, Fish oil will reduce blood pressure and it is from my experience. I remember you are taking it.
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No, I didn't ask for it. This scleroderma doc is probably the world's most reknown scleroderma doc and researcher. He asked me about my tolerance for exercise, and I told him that mild exertion made me huff and puff. That's when he ordered the test. Scleroderma can cause a whole host of bad effects on the heart. So he was really on his toes with the right testing. I think he's good, and I'll probably stick with him. I do wish, though that he were a little more communicative. I'd really like to know if I should aim for a lower target pulse rate when exercising.
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Sorry to hear about your test results, Hallie. Hang in there, and take good care of yourself.
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Hi,
I would think you'd have a lower target pulse when exercising! You're putting a lot of stress on your heart- anyway, as you already know, the best type of exercise is slower than what was once thought- helps burn the fat although I'm sure you're doing it primarily for heart health. It's always the unknown that bothers us, isn't it? Maybe he'll have that answer for you next time you talk with him. In any case, I'll bet if he doesn't have that answer, he'll get it- am so glad you have the best dr. around!
Last edited by marjie (2009-12-13 09:07:18)
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Thank's everyone. It's great to know you're all there for me to talk to. You're all the best!
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HI, all
I have recently come across some information and wanted to see what others have found. I went to MD Anderson to have all the tests for ruling out myeloma. I asked the nurse practitioner if they based their tests on the Drurie-Salmon method. I didn't really get a strong answer from her. When all the numbers came in, the n.p. said that I was between MGUS and assymptomatic myeloma but that the dr. would have the final say. The dr. said MGUS and to recheck in 3 months. After returning home, I decided to check on the Cancer Treatment Centers of America. I think the way they classify myeloma is by using the B2M as one of their major determinants and that the Drurie-Salmon classification was not used as much. Now, I was exhausted and could be completely wrong- has anyone else read/heard/experienced this? This would definitely make sense in my case if the n.p. said one thing and the dr. another - they were weighing tests differently. I go back in May so will definitely ask!
Thanks,
Marjie
Last edited by marjie (2010-02-21 16:06:10)
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Hi Marjie,
My B2M value is also high 2.90 but considered as MUGS based on other markers low IgG , Normal K/L ratio, < 5% plasma cells in bone marrow .
I have some infection in my body and it raised B2M not because of progression. Hope this helps.
Thanks,
Veela
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Thanks, Veela
My B2M was high as was my K/L ratio, IgG above normal. My plasma cells were 5%. I think the Cancer Centers of America said that they looked at B2M and albumin levels to determine the 1st stage of myeloma.
I didn't realize that B2M could be an indicator of infection! Thanks for the info!
Marjie
Last edited by marjie (2010-02-22 18:52:44)
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Not doing good. When I had a MRI done 2 weeks ago I found out Kabba -L chain spike was 7 In Dec it was a one. What happens next. Sorry long time haven't been on line. I love that K/L was mentioned.Any ideas
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Marta, I'd like to help, but I can't until you show the units for those lab tests, and the exact name of the tests. Please go back to your lab test reports and make sure of the name of the test and the units. And be sure you are comparing the same one last time and this.
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Hi, I am receiving IVIG every 28 days and have developed shortness of breath, my lungs are okay and heart is fine. It has made me homebound to a certain extent. I see my MGUS doctor tomorrow, but he always says my m protein is to low and can't be causing me any problems. I get the Immunoglobin IV from my immunoligist and I see him in 3 weeks. Has anyone had the same problem with the IV treatement?
Thanks,
kansasgal
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IVIG can sometimes cause pulmonary edema from fluid overload, due to the high colloid oncotic pressure of IVIG. This would result in shortness of breath.
Your doctor should either do the following, or refer you to a cardiologist who will:
1. listen for crackles or abnormal heart sounds, and check your pulse rate
2. measure respiration rate, observe whether skin color is bluish
3. measure your blood oxygen level; check your hemoglobin
4. do a chest x-ray to check for fluid in or around the lung space, or an enlarged heart
5. do an ECG (EKG) to check for abnormal heart rhythm
6. do an echocardiogram to check flow rates within the heart and surrounding vessels, check for weak heart muscle, leaky or narrow heart valves, or fluid surrounding the heart.
I have been huffing and puffing with mild exertion for several years, and an echocardiogram recently revealed that my left ventricle is not relaxing and refilling properly between beats, because the heart muscle is stiffening. I also get edema in my ankles because of it. The echodardiogram is non-invasive, painless, and really yields a lot of information about heart- lung function.
7. If the echogram shows anything, he should also consider doing a metabolic stress test to assess how well your heart and lungs are working when you are under a bit of physical stress. With that test, you breath into a respirometer while walking the treadmill, with simultaneous ECG being recorded.
If these tests show a problem, your doc may need to reassess the IVIG therapy. Why do they have you on it, anyway, if your M-spike is so low? Have you had a bone marrow biopsy? How are your hemoglobin, K/L ratio and beta-2-microglobulin?
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Hallie,
Is the echocardiogram a part of the treadmill/stress test, or ekg? Or, do you have to request it?
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No, these are two separate tests. I had my echocardiogram, and it showed that the heart muscle was not relaxing and refilling properly between beats because it is becoming stiff. It's called restrictive cardiomyopathy. In my case this is probably because of one of 3 things:
1. scarring from "silent" coronary artery disease (Dad had early coronary artery disease.)
2. amyloidosis from the MGUS.
3. myocardial fibrosis from my anticentromere antibodies, which are extremely high, and known to cause stiffening of organ tissues. These antibodies are pretty closely associated with scleroderma, which even before hardening the skin, can harden internal organs.
My metabolic stress test, because of snow, was rescheduled for March 24th.
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Thanks again Hallie, I had my heart and lungs check and they are not causing my problem. The reason I'm on IVIG is because of Igg subclass deficientcy. My Igg 2 my Igg 3 is to low, so my immunologist prescribed the IVIG so I wouldn't have infections all the time.
My heart Doctor is referring me to a new Doctor to be my guide, he thinks there is a thyroid problem or choride problem. I like my heart, immunologist and hematologist and am blessed but my other Doctor's blew me off.
Iga is 136 (good)
Igg is 1396 which is to high and did a subclass test( 4 sub-classes) which 1 was 890, 2 was 63, 3 was 11 and 4 was 12.
Igm is 32 (low) but I don't think there is anything they can do with that.
My hematologist said my M Protein is stable along with everything else, but there is no connection to immune deficientcy. The Immune Deficiency Foundation has alot of information on their web sight, they also think it could be the IVIG. So I will talk to my Immunologist in 3 weeks, after my cataract surgery.
I must tell you a funny at night if I have a chest cold, my vocal cords ring and when it first happen I look at my dog and she look at me and I realized it was me. I have vocal cord dysfunction. You have to laugh at some things or you'd go crazy.
Sorry to hear about your problems, I wish well, you have helped so many people, you definitely have earned your wings but there's alot more time left before you get them.
Thank you again,
Geri
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Hallie,
Do you have trouble with high blood pressure?
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