Does anyone else have MGUS?

Posted by mjlandin @mjlandin, Jun 4, 2022

I was diagnosed with MGUS last October and although I've done a lot of research, I feel there's still so much I don't know. Does anyone else have MGUS?

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@pmm

Teresa you hit the nail on the head for expressing my perspective. I’m grateful that I get quarterly blood analysis both to monitor the MGUS, but also my overall health. Who gets that kind of information quarterly?
The trick for me has been to relax and have confidence that my medical providers are paying attention.
Additionally, my doc keeps me appraised of treatment advances in the event my MGUS progresses. That inspires both hope and confidence. The statistics are on our side. Data rocks.
Have a happy holiday.
Patty

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Hope your holidays were wonderful and that 2023 is off to a great start for you!! How long have you known you had MGUS? I think I'm 11 years in now 🙂

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@mommatracy5

Hi, I’m 49 years old and just got an Mgus diagnosis. I’ve been trying to find out all I can and have so many questions. I’d like to connect with other Mgus people with more experience and knowledge. Thank you!

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Did an anesthesiologist reject using your CPAP at Mayo during a colonoscopy? I have found most everyone of my Drs at Mayo Clinic to be quite accommodating. You've had an experience I haven't - visiting the Mothership in Rochester! I imagine it was every bit as impressive as you indicated!! I recently talked with the Clinical Trial Co-ordinator for all 3 Mayo locations and it's possible I may venture there myself for an MGUS diet/exercise study or a
post DCIS trial using metformin. Thank you for the good thoughts, but that splenic flexure cancer is long gone thanks to the skilled surgical hands of "Dr C" at Mayo JAX. In fact we did the 1 year follow up colonoscopy a month ago and I remain cancer free!! Things looked so good I don't have to have another for 3 years so WOOHOO. As they say in the South, God willing and the creek don't rise, I will NEVER have a colonoscopy anywhere except right there ever. I had an awful experience in Tallahassee with the one ordered because of the low ferritin that delayed formulating a treatment plan for the cancer and necessitating tests at both Mayo and a 2nd Comprehensive Cancer Cancer in FL before we knew whether to refer me for surgery or oncology first. I used to live in Scottsdale where Mayo Clinic built their AZ hospital and clinic. I don't know whether to say I'm sorry you went by yourself to Rochester as I often do the same myself. Like you, as someone who has taken care of so many loved ones myself at these places, most of the time I prefer flying solo since it's natural for me to be more concerned about how others are handling things than worrying about myself, and honestly, I prefer processing results and things on my own before putting it out for public consumption. I'm going over often enough that I just leased a place in Jacksonville on a month to month basis to try on living there! I have someone holding down the fort for me in my little house in Tallahassee until I decide and until after I finish a 3 week intensive program through Pain and Rehabilitative Medicine which I'm super pumped about doing! I may feel so much better at its conclusion, I won't need to hardly ever go back, but if I fall in love with it or continue having problems, I have a place!! I looked a bit in the Phoenix area first and other places by top notch medical centers, but this all just kinda fell in my lap. Like you, I'm a warm weather gal and not sure I could do Rochester all the time. Did you freeze to death up there??

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@tallyteresa

I also participate in the Promise trial at Dana Farber 🙂 Looks like we are getting closer to finding a way to slow or halt progression with their work and again with the huge sampling in Icelandic and new info coming in from that at lightning speed. Re: the low ferritin...turns out the problem was in my colon, not marrow. My PCP and I pushed for an early colonoscopy just to rule out bleeding there and sure enough, without any symptoms, we found a mass in the splenic flexure. So sometimes, answers can be found with endoscopy and/or colonoscopy. I applaud you for pursuing this. Out of curiosity, is your hemoglobin level normal? Often when it is, some Drs won't then include
a full iron or anemia panel which can be important. My last iron infusion was given for low saturation % while the ferritin level was fine. My local hematologist says one can't be anemic with normal hemoglobin or considered as exhibiting that CRAB feature, yet if I didn't have the iron infusion, I would become anemic. Looking forward to asking Dr A what he thinks about that. Would letting it be and then having anemia change my status? My calcium is now just outside of range, too, so I'm most looking forward to seeing him soon. Which Mayo are you going to if you are comfortable saying?

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Thanks for your response and this conversation, @tallyteresa. My hgb and hct have both tended on the high side of normal. If I do not drink enough water or ginger tea both can go above normal and when both are elevated that high combo gets a new dx name: ERYTHROCITOSIS. I'm due to check my colon. Since I have obstructive sleep apnea and faithfully use an Apap, I do not do colonoscopies. I would, but twice when I had a colonoscopy the anesthesiologists were too arrogant to use my CPAP during the procedure.

Don't worry, if anything happens I'll be here! They apparently refuse to understand that using a pap prevents anything from happening.The American Sleep Apnea Association advises people with sleep apnea to take their AUTOPap or CPAP apparatus with them for procedures. They can not work if anesthesiologists refuse to use them. Instead I will cease any vitamin C, (no Preservision) then do three fecal smear card tests, then an Exact Sciences Cologuard test will be ordered by my PCP. It's been three years since the last one so Medicare will pay for it. I live in Los Angeles and had hoped to drive to the Arizona Mayo Clinic. Mayo insisted I go to Rochester, MN instead. I completely followed their guidance, right down to paying $25 extra for their travel guide's recommendations. Which hotel, even to stay on a concierge floor. Excellent! Though I was there alone (already having been a past caregiver for both parents and husband while their lives ended) dining in the small dining room with interesting others meant I never felt lonely. An extra Bonus was that when I needed to stay longer Mayo covered the extra charge to change Delta flights. I loved being there; exploring their fabulous art collection was a joy around every corner. During my week and a half was time to take in a nearby concert as well as other events: in short be an exploring tourist in the community. People in real winter areas live differently than Californians. Especially in December. Going to Mayo Clinic became a vacation with medical benefits. Were it not for ongoing Covid sequestration I would have already returned. You've given me more to google: full iron panel or anemia panel. Thank you!  Already googled your Dr. A. Hope your colon splenic flexure and calcium situations will normalize. Thanks again!

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@raye

@tallyteresa, you are an inspiration! I appreciate your in depth research and following your hunches on looking into low ferritin. You encourage me to dig into my own low ferritin cause with two of my doctors. And I’ll now research liquid biopsy. I contribute my blood to DFCI’s PCROWD research and encourage relevant others to do so also.

For @gilash1965, regarding MGUS, there are different types, for IgM MGUS Dr. Kyle did not advise BMB several years ago. He may have advised it for IgG MGUS at the time. And medical research is dynamically moving on. Concurring to get other opinions before deciding against following medical advice.

Regarding connecting with a Comprehensive Cancer Center, I’m uncertain how to determine the rating of mine. Cedars-Sinai’s Tower Hematology/Oncology in Los Angeles is one I’m using.

Thank you again, Telly Teresa. I will pursue learning the cause of my low ferritin.
May we all keep on keeping on!🤗 HUGS🤗

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I also participate in the Promise trial at Dana Farber 🙂 Looks like we are getting closer to finding a way to slow or halt progression with their work and again with the huge sampling in Icelandic and new info coming in from that at lightning speed. Re: the low ferritin...turns out the problem was in my colon, not marrow. My PCP and I pushed for an early colonoscopy just to rule out bleeding there and sure enough, without any symptoms, we found a mass in the splenic flexure. So sometimes, answers can be found with endoscopy and/or colonoscopy. I applaud you for pursuing this. Out of curiosity, is your hemoglobin level normal? Often when it is, some Drs won't then include
a full iron or anemia panel which can be important. My last iron infusion was given for low saturation % while the ferritin level was fine. My local hematologist says one can't be anemic with normal hemoglobin or considered as exhibiting that CRAB feature, yet if I didn't have the iron infusion, I would become anemic. Looking forward to asking Dr A what he thinks about that. Would letting it be and then having anemia change my status? My calcium is now just outside of range, too, so I'm most looking forward to seeing him soon. Which Mayo are you going to if you are comfortable saying?

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@pmm

I will have to explore the liquid biopsies. Interesting, thanks!
PMM

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Looks promising in that myeloma cells usually appear in a patchy areas in the marrow as I understand it whereas serum (blood) likely provides a more accurate picture of what's going on throughout it. Let us know if you learn more on how close they are to shifting to liquid or if it still seems an acceptable replacement, please.

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@mommatracy5

Hi, I’m 49 years old and just got an Mgus diagnosis. I’ve been trying to find out all I can and have so many questions. I’d like to connect with other Mgus people with more experience and knowledge. Thank you!

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Thank you very much, Colleen.

I’m very fortunate to have been given the direct email addresses by both my PCP and hematologist. I try not to overly use them. However pursuing the cause of low ferritin is important.

Please know that I value you.

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@raye

Thank you, Colleen. I’m glad you found something about my comments worthwhile and hope they can be helpful to others. My rheumatologist diagnosed my IgM was elevated. That meant I had MGUS. He sent my test results to my PCP who should have sent me to a hematologist but she didn’t. So I chose one at random and he said goodbye before saying hello. He did very few blood tests. Didn’t like him. That’s why I went to Mayo Clinic, though it turned out to be more helpful with other health concerns. Dr. Lusk knew less about some things than I did and he was not helpful with hematology. Next I went to City of Hope. Dr. Rosenzweig said I had leukemia. Why do you say that? Because I don’t have MGUS in my computer pull down list. He really said that. Obviously I was in the wrong place! Then I went to hematologist James Berenson. He knew how to game the system to get $300,000 annual income from drug companies for testing their new products on patients. (Check docs in ProPublica Dollars for Docs.) He wanted to make me into one of his test subjects. On my first and only visit he asked me to sign a 14 page agreement giving him permission to test things on me. No thank you! Of course he was eager to do a bone marrow biopsy! Time to leave. He had already revealed his true color. 

After this round about journey, eventually I got a referral to a hematologist I like. It's been a couple of years with him so far. He's ordered a variety of blood tests and genetic studies. (All genetic were negative, which is good. At least he looked.) More specific diagnosis is that I have IgM kappa MGUS. A painful bone marrow biopsy has not been otherwise been recommended since diagnosis seven years ago. A CT scan was done. See Robert A Kyle's writing on Bone Marrow Biopsies, 1987. He put the US in MGUS and is a great gift to our field of need He did not recommend BMB for IgM MGUS. Some patients may need this test, which will be worthwhile to undergo when they do. A friend who had it said he wished he had been under anesthesia for the procedure. 

And now for something completely different: I'm in a quandary about a question to my hematologist which he did not answer. I had asked why my ferritin is low and his conversation went to all sorts of things. I found myself subsequently sending him contacts which could be helpful to his Prius or his broken refrigerator. Poor guy. A storm of things went wrong in their house, and he loves playing ice hockey(!) Don't you love non-sequiturs? 

However I still do not know why my ferritin is low. What do you suggest? Just write him a direct question repeating this concern? Sometimes one does not know how to gently be repetitive without fearing coming across as assertive. Sorry for this long journey-in-healing diatribe, dear Colleen. Cheers! Happy healthy new year! 

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Hi @raye, I fixed the odd formatting issues with your post. I think the extra coding was added when replying by email.

With respect to your question about following up with your physician about your low ferritin, I recommend that you send your question through the patient portal if you have one. If now, it sounds like you have a communication chain with him. Email? Then I would use that.

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@tallyteresa

I've had 2 or 3 bone marrow biopsies since learning I had MGUS 11 years ago. All were at my request, performed at Mayo Clinic JAX, and virtually painless. I did feel the lidocaine injection and
then some brief pressure, but it was over within 20 minutes after I arrived at the clinic. Bless my late husband's heart, his own quarterly bone marrow biopsies for most of 14 years due to a rare form of CLL really were painful. I was allowed to watch all but one of his in various clinics around the country and they were so painful he'd be in bed for 2 days after. I learned too late for him that it matters who does them and where. At Mayo JAX for example, you have 2 nurses who each do 7 bone marrow biopsies every work day and it shows. Subsequent biopsies have been as easy as my first, so for me, it
was an reasonable ask to reassure myself that an increase of plasma cells weren't the cause of new symptoms. Two primary cancers were found early in my own body in the past 2 years because of one routine screening and another one scheduled a year early because of a gut feeling one of my Drs and I had about my low ferritin. So I personally am reluctant to dismiss the value of having what has been an easy for me "screening" of my bone marrow for anyone who wants one for peace of mind if nothing else. Nor would I say to you or anyone else that the choice not to have one isn't the right choice for you unless it is only because you think it's going to be painful which doesn't seem to be the case here. Anyone who
is concerned about the possibility of pain should be aware though that they can request light anesthesia if they feel they want or need it.

I'm actually seeing Dr Ailawadhi again this month and plan to ask his opinion about doing another biopsy since it's been 3 years and there are some changes. My involved light chain went off the chart after steadily increasing over the years, I'm having more iron infusions, recurrent infections, and Bence Jones protein popped up in the 24 hour urine for the first time. I have developed neuropathy, am fatigued, and recently, a CT scan for something unrelated shows a healed spontaneous rib fracture that wasn't there last year. And my ANA came back positive though the
associated autoimmune disease markers were negative. The rib could be from a short round of radiation and the ANA could be from previous COVID infection, but taking another look seems prudent since we have learned from the Icelandic study that anyone can progress at any time. For the newly diagnosed, I am excited to see that a new formula was recently revealed at ASH I believe that determines when a baseline biopsy should be performed vs not that appears to be so stunningly accurate, it will likely replace the standard protocol established by the Dr who discovered
and named MGUS, Richard Kyle from Mayo Rochester decades ago. Cancer research moves at lightning speed and the use of liquid biopsies at Dana Farber and elsewhere is also promising as a possible replacement for traditional bone marrow biopsy methodology. I applaud you for taking a deep dive and for seeking
opinions from some of our best researchers. One thing I've learned over the four decades of advising newly diagnosed cancer patients is they need to get to an NCI designated Comprehensive Cancer Center before the first treatment is administered. Data is undeniable - patients who seek counsel at these centers live longer and better. Best of health to you 🙂

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@tallyteresa, you are an inspiration! I appreciate your in depth research and following your hunches on looking into low ferritin. You encourage me to dig into my own low ferritin cause with two of my doctors. And I’ll now research liquid biopsy. I contribute my blood to DFCI’s PCROWD research and encourage relevant others to do so also.

For @gilash1965, regarding MGUS, there are different types, for IgM MGUS Dr. Kyle did not advise BMB several years ago. He may have advised it for IgG MGUS at the time. And medical research is dynamically moving on. Concurring to get other opinions before deciding against following medical advice.

Regarding connecting with a Comprehensive Cancer Center, I’m uncertain how to determine the rating of mine. Cedars-Sinai’s Tower Hematology/Oncology in Los Angeles is one I’m using.

Thank you again, Telly Teresa. I will pursue learning the cause of my low ferritin.
May we all keep on keeping on!🤗 HUGS🤗

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@raye

Thank you, Colleen. I’m glad you found something about my comments worthwhile and hope they can be helpful to others. My rheumatologist diagnosed my IgM was elevated. That meant I had MGUS. He sent my test results to my PCP who should have sent me to a hematologist but she didn’t. So I chose one at random and he said goodbye before saying hello. He did very few blood tests. Didn’t like him. That’s why I went to Mayo Clinic, though it turned out to be more helpful with other health concerns. Dr. Lusk knew less about some things than I did and he was not helpful with hematology. Next I went to City of Hope. Dr. Rosenzweig said I had leukemia. Why do you say that? Because I don’t have MGUS in my computer pull down list. He really said that. Obviously I was in the wrong place! Then I went to hematologist James Berenson. He knew how to game the system to get $300,000 annual income from drug companies for testing their new products on patients. (Check docs in ProPublica Dollars for Docs.) He wanted to make me into one of his test subjects. On my first and only visit he asked me to sign a 14 page agreement giving him permission to test things on me. No thank you! Of course he was eager to do a bone marrow biopsy! Time to leave. He had already revealed his true color. 

After this round about journey, eventually I got a referral to a hematologist I like. It's been a couple of years with him so far. He's ordered a variety of blood tests and genetic studies. (All genetic were negative, which is good. At least he looked.) More specific diagnosis is that I have IgM kappa MGUS. A painful bone marrow biopsy has not been otherwise been recommended since diagnosis seven years ago. A CT scan was done. See Robert A Kyle's writing on Bone Marrow Biopsies, 1987. He put the US in MGUS and is a great gift to our field of need He did not recommend BMB for IgM MGUS. Some patients may need this test, which will be worthwhile to undergo when they do. A friend who had it said he wished he had been under anesthesia for the procedure. 

And now for something completely different: I'm in a quandary about a question to my hematologist which he did not answer. I had asked why my ferritin is low and his conversation went to all sorts of things. I found myself subsequently sending him contacts which could be helpful to his Prius or his broken refrigerator. Poor guy. A storm of things went wrong in their house, and he loves playing ice hockey(!) Don't you love non-sequiturs? 

However I still do not know why my ferritin is low. What do you suggest? Just write him a direct question repeating this concern? Sometimes one does not know how to gently be repetitive without fearing coming across as assertive. Sorry for this long journey-in-healing diatribe, dear Colleen. Cheers! Happy healthy new year! 

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Woooh! Formatting must have had a seizure during the repost!
Welcome @raye

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@mommatracy5

Hi, I’m 49 years old and just got an Mgus diagnosis. I’ve been trying to find out all I can and have so many questions. I’d like to connect with other Mgus people with more experience and knowledge. Thank you!

Jump to this post

I will have to explore the liquid biopsies. Interesting, thanks!
PMM

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