Another Tardy Update

I've had a few medical issues over the last couple of months.  I had an MRI of my cervical spine, two head-to-toe PET scans, a cardiac stress test, a dermatology visit, and an eye test. Life seems to be turning into a succession of medical appointments. 

In the meantime, I continued my monthly visits to Dana Farber on my clinical trial. The good news is that I am still in remission from the MM. My last visit was on May 9, and my free light chain ratio remains normal, with no detectable M-spike. That's all good, but some of the other results aren't as rosy. 

My cardiac stress test showed some plaque in my left ventricle, so my doctor wants me to schedule a fasting cholesterol test. I don't think that will be a problem, because I get my cholesterol tested every month at Dana Farber without fasting, and it's usually in the 170-180 range, which is normal. 

I had 5 biopsies for my dermatology visit, and all 5 were positive: 4 squamous cells and 1 basal cell carcinoma. They are on my scalp (2), chest, left arm, and right arm. When I pointed them out to my landlord, Garry, I made the sign of the cross to show him where they were, so he now calls me "Father Bill" 😊. I have scheduled 2 appointments to have them removed. 

My eye test showed some issues with my field vision, which could be indicative of glaucoma. I have scheduled a repeat test for next month.

The biggest issues are with the PET scans. The PET scan in March showed 2 problems: nodules in my left and right lungs, and some tracer uptake in my cervical spine, especially vertebra C4. My latest PET scan on May 9 showed mixed results. Fortunately, the nodules on my lungs have either completely or partially resolved, so thankfully, they don't seem to be an issue. I had scheduled a follow-up CT scan in June, which has now been canceled. Yay!

However, the nodules in my cervical spine have increased. The tracer drug I had injected was FDG, a type of glucose that shows cancer activity. These show increases in my C4 vertebra and a nearby lymph node, likely related to Multiple Myeloma.

I messaged Dr. Richardson for his take on these results. His nurse got back to me, suggesting that I schedule an appointment with a radiation specialist. It looks like I might be in for some radiation treatments for this condition. Rats! Fortunately, I don't have any pain or restricted movement in my neck, so that's a positive.

I'm confused. My clinical trial is going so great! I have no M-spike, and my free light chains are still in the normal range. How can this be? After a little research, I discovered that I might have extramedullary disease (EMD), where only light chains are secreted, even without a detectable M-spike in the blood serum. Shit! So these light chains may only be detectable in the urine (which I haven't provided for the last couple of months). I will provide a 24-hour urine sample at my next visit.  I need to have a conversation with Paul about this. 

I don't think I'm about to expire from high cholesterol, skin cancer, glaucoma, or MM any time soon, so I expect to be around to give an update on all these findings. 😀