MGUS I need help understanding my lab report.

Posted by nsnipes11 @nsnipes11, Dec 29, 2023

I've had MGUS for about 10 years, give or take. Next year, I'll be 80. Since I've been dealing with other issues: coronary artery disease (one stent); neuropathy, cervical stenosis (severe degenerative disc disease cervical and lumbar), osteoporosis, asthma, Barrett's esophagus and other smaller issues, I haven't paid a lot of attention to the MGUS.
My lab work says "immunofixation shows IgG monoclonal protein with lambda light chain. My M-spike is 1.5. My IGg is 1819. My Lambda is 27.00. K/L Ratio 0.39; RBC is 3.50; HCT 34.7; MCH 34.2; GLUC 110.0; CREA 1.1; eGFR 53.
My oncologist was out of the office, and a nurse practitioner said all was well last visit, and again this visit my doc was not available. I will see her next week. I just wonder if I should consider seeing someone else. I have also been experiencing sharp pains in mid-back and hips. They don't linger though. Any thoughts are appreciated.

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Hi, @nsnipes11 - I can't interpret your labs very well but didn't want your question to go unanswered. That's always such a bummer!

Do you have access to a Portal where you can just drop your doctor a question about the values instead of having to wait for a visit? Sometimes getting an answer in writing can clarify questions better than even a phone call, and in my experience, don't entail waiting more than a day or two.

Best wishes,
Nancy

EDIT: Also, maybe someone else here will have had similar labs and can respond better than me. Doesn't hurt to bump the question up in the feed!

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@nsnipes11
Greetings! Don’t you love all these complicated lab reports that you get on the patient portal? One of the tricks that I have learned is to coordinate my appointments and labs so that I go in and get the lab work done a few days before my appointment with my hematologist/oncologist. That way I am sitting in the room with him as he is looking at them and he can explain them all to me. I also make it a practice not to look at the patient portal ahead of time so I get all my questions answered when I’m actually in the room with him. That works for me but it’s hard to control the impulse to look ahead of time.
I have learned enough in the last three years to cut to the chase and look at the elevations that would definitely be a red flag. I think most of us are reluctant to interpret somebody else’s lab work, however. I’m sure that there are people that are well trained or self educated enough to do that, but it’s really best that you get your interpretation from your actual physician.
You can call and make an appointment for the express purpose of going over your lab work and having a conversation about what it all means and concerns, if any, that the physician might have. This can be done on the phone, but I personally prefer to sit in the room with my doctor and have a conversation. It’s important that you advocate for yourself so that you get your questions answered. If your physician is reluctant to do that, maybe you have the wrong doctor.
Having said this, I’m glad that you elected to join the forum and I hope that you get back to us and let us know how you’re doing from time to time. This is a very compassionate and interesting group of people. It’s always good to have support from peers.
Best wishes for good health outcomes and a happy new year.
Patty
.

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Agree with above comments- I might add that the trend is important. How different or similar are these from the last labs?

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@nancyworld

Hi, @nsnipes11 - I can't interpret your labs very well but didn't want your question to go unanswered. That's always such a bummer!

Do you have access to a Portal where you can just drop your doctor a question about the values instead of having to wait for a visit? Sometimes getting an answer in writing can clarify questions better than even a phone call, and in my experience, don't entail waiting more than a day or two.

Best wishes,
Nancy

EDIT: Also, maybe someone else here will have had similar labs and can respond better than me. Doesn't hurt to bump the question up in the feed!

Jump to this post

Hi, Nancy.

Thanks for responding. I just understand so little about my labs, that I don't really know what to ask. I see where some things are high (or low), and I don't know what that means for me, and if I should be concerned. Like I said, I am dealing with other issues and don't have a lot of time to spend on MGUS, if things are going well. I don't feel as if the doctor is following my labs too well. I haven't had a urine test in a long while. I will be asking about that, for sure.

Again, thank you for your response. It is much appreciated.

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@pmm

@nsnipes11
Greetings! Don’t you love all these complicated lab reports that you get on the patient portal? One of the tricks that I have learned is to coordinate my appointments and labs so that I go in and get the lab work done a few days before my appointment with my hematologist/oncologist. That way I am sitting in the room with him as he is looking at them and he can explain them all to me. I also make it a practice not to look at the patient portal ahead of time so I get all my questions answered when I’m actually in the room with him. That works for me but it’s hard to control the impulse to look ahead of time.
I have learned enough in the last three years to cut to the chase and look at the elevations that would definitely be a red flag. I think most of us are reluctant to interpret somebody else’s lab work, however. I’m sure that there are people that are well trained or self educated enough to do that, but it’s really best that you get your interpretation from your actual physician.
You can call and make an appointment for the express purpose of going over your lab work and having a conversation about what it all means and concerns, if any, that the physician might have. This can be done on the phone, but I personally prefer to sit in the room with my doctor and have a conversation. It’s important that you advocate for yourself so that you get your questions answered. If your physician is reluctant to do that, maybe you have the wrong doctor.
Having said this, I’m glad that you elected to join the forum and I hope that you get back to us and let us know how you’re doing from time to time. This is a very compassionate and interesting group of people. It’s always good to have support from peers.
Best wishes for good health outcomes and a happy new year.
Patty
.

Jump to this post

Thank you, Patty, for the good advice. My doctor just doesn't have time anymore. I've tried to write the patient portal, but have received no response. I've just assumed that if there are any issues, she would let me know. I know to be my own advocate, and I've read quite a bit about MGUS, but have gotten more confused than when I started. LOL. As I said, the doctor seems to be allowing the nurse practitioner to take over more. I saw the NP once, but the next time, I expressly said I wanted to see the doctor. I completely understand there are many patients who are far worse off than I am, so I'm reluctant to take up too much of the doctor's time.

I'll be seeing her next week for recent labs, which were done in two different labs. A partial one at her office by one lab and one by Quest, who did my cardiac labs.

Thank you for all your good advice.

Nan

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@nsnipes11

Thank you, Patty, for the good advice. My doctor just doesn't have time anymore. I've tried to write the patient portal, but have received no response. I've just assumed that if there are any issues, she would let me know. I know to be my own advocate, and I've read quite a bit about MGUS, but have gotten more confused than when I started. LOL. As I said, the doctor seems to be allowing the nurse practitioner to take over more. I saw the NP once, but the next time, I expressly said I wanted to see the doctor. I completely understand there are many patients who are far worse off than I am, so I'm reluctant to take up too much of the doctor's time.

I'll be seeing her next week for recent labs, which were done in two different labs. A partial one at her office by one lab and one by Quest, who did my cardiac labs.

Thank you for all your good advice.

Nan

Jump to this post

@nsnipes11, I think you should've gotten a response to your questions on your Portal. I really don't think you should take a back seat to patients who are worse off, in the sense that the doctors and clinics must organize their time to take care of EVERYONE who needs their care. That's up to them.

I've been struggling, myself, with wanting answers but not wanting to be a pest. But as Patty said above, we patients are entitled to explanations about our lab work and plan of care, given in a face-to-face visit. I honestly didn't realize that myself, but my sister, a retired nurse, has made a point of telling me that - over and over! 😂

So don't feel bad about asking the doctor for that. The lab results are YOUR information about YOUR body, and you have a right to understand what they mean. We can't get an MD degree from reading online, and that's what the MDs are getting paid for, anyway.

Take care and let us know how it goes! ❤️

Nancy

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@nsnipes11, just wanted to check in. Did you get a more specific interpretation of your lab results at your last visit with your doctor?

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@colleenyoung

@nsnipes11, just wanted to check in. Did you get a more specific interpretation of your lab results at your last visit with your doctor?

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Thanks for asking, Colleen.
Actually, the doctor didn't give me a chance to ask as she changed the subject to other health issues I have. By the time I answered her questions, I was completely sidetracked. I know. It's my fault. I'll ask in July when I see her again.
Thanks again, Colleen.
Nan

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@nsnipes11 , I'm sorry you didn't get to discuss your MGUS concerns with your doctor. It can be hard to stay on track if they have a lot of things to go over.

I started to take a crack at comparing your immunoglobulin test values here with the Mayo (at least) standard ranges for those tests, and then realized that I don't know if the amounts are in mg/dL or mg/L. It makes a big difference! And different labs use different reference ranges for some lab tests.

Do you possibly have the reference ranges for those lab tests in your reports, and the units of measure (mg/dL vs. mg/L)? If so, maybe I or someone here can help put the results in perspective.

Even so, it can be tough to do without knowing your other physical conditions that can affect some of the measures, especially since most of us don't have the medical knowledge to figure out how one condition can affect another. I'm just empathetic because I'm trying to assess my own situation.

Best wishes, Nancy

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@nsnipes11

Thanks for asking, Colleen.
Actually, the doctor didn't give me a chance to ask as she changed the subject to other health issues I have. By the time I answered her questions, I was completely sidetracked. I know. It's my fault. I'll ask in July when I see her again.
Thanks again, Colleen.
Nan

Jump to this post

@nsnipes11 ugh. How frustrating. I encourage you to call your doc and set up a time for a telephone appointment to go over your lab results with you. Your treatment team is the best source of information.
It’s important for two reasons. First and foremost you need the information to make informed health decisions. But also, these docs are busy. I’m sure some do pay attention to every lab report that comes across their computer screen, but if they go over your labs with you, then you know they have read them thoroughly. I do this every time I go see my hem/onc guy. I write down questions beforehand and I make a deal out of checking them off my list as we discuss them. I have confidence in my team, but I make sure I do my part to be a responsible patient.
You shouldn’t have to wait until your next appointment. Advocate for yourself. Be polite but firm. Don’t take no for an answer.
Let us know how you do!

Patty

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