If your M spike is at 3 and you have neuropathy, you need to see a myeloma specialist at a center that sees a high volume of patients.
I have had MGUS since 2002. The M spike has varied from 1.1 to 1.7 and back down again. I think my hydration at the point of the blood draw may be responsible for the variation.
I also had a fractured hip that was replaced in January 2021. Surgery was done under regional anesthetic not general anesthesia. My free light chains went up and then came back down again. The M spike did not change. However, when I had a reverse shoulder replacement surgery in 2023 under a half hour of general anesthesia, my free light chains soared. They have decreased but not to the level they were before I had the surgery. I do not understand why as I had no problems with the surgery and feel great now.
My previous (now retired) hematologist wanted my bloods drawn every three months. The current one in the same practice thinks yearly is fine -- and every six months if I choose. I do choose every six months.