Wednesday, November 18, 2009

So...Do I worry now or later?


Finally my doctor has returned from his two week vacation and I finally get the results from the other blood test.

He stated that my blood test does show some slight elevation of my light chains...
I know you are like me...WHAT?
What the heck are light chains and why are they in my blood?

You know when you are sitting in the doctor's office and they are talking to you about all of these things and yes you are hearing them speak but you are really not listening...yes we are all guilty about it....and then they begin to speak in all of these big words and then before you know it you are nodding your head to Charlie Brown's teacher ...remember...wha wha wha...

So in a nut shell...Dr. Perselin (My RA) doctor is going to consult again with Dr. Likinstein (Hemotologist) again...because if you all remember they found something in my marrow over the summer then said no don't worry about it but now here we are again with the "LIGHT CHAINS" blood work....ugh....and they will call me after they "confer" to see what the next step is going to be if any....

So before you all kill me the research that I have found states this:

Multiple Myeloma and Monoclonal
Myeloma is a cancer of the plasma cells in the bone marrow. Myeloma is synonymous
with multiple myeloma and plasma cell. neoplasm. Plasma cells produce antibodies,
also known as immunoglobulins, which are proteins that help fight infection. Each type
of plasma cell produces only one type of immunoglobulin. There are many different
types of plasma cells in the body, resulting in the production of a variety of different
immunoglobulins. In multiple myeloma, one particular type of plasma cell is duplicated a
very large number of times, causing excess production of one type of immunoglobulin,
which is referred to as a monoclonal protein, or M-protein. M-protein is also called
myeloma protein, para-protein, or the protein spike. M-protein is important for diagnosis
and for monitoring treatment in multiple myeloma. The free light chains are derived
from the monoclonal protein (See Figure 1).

What are Free Light Chains?
Immunoglobulins or monoclonal proteins are composed of two types of smaller molecules,
one called a heavy chain and the other called a light chain (see Figure 1). There are five types of heavy chains, referred to by letter, with the abbreviation for immunoglobulin (Ig) before the letter: IgG, IgA, IgM, IgD, and IgE. There are two types of light chains, referred to as kappa (κ) and lambda (λ). Each plasma cell produces only one type of heavy chain and only one type of light chain. The heavy and light chains are produced separately within the plasma cell and are then assembled to form a whole immunoglobulin. When the light chains are attached to the
heavy chains, the light chains are referred to as bound light chains. However, when the
light chains are not attached to the heavy chains, they are called free light chains. For
unknown reasons, the plasma cells typically produce more light chains than are required
to create the whole immunoglobulin or monoclonal protein. The excess light chains enter
the blood stream as free light chains (i.e. unattached to the heavy chains). Thus both in the normal situation and in patients with myeloma and monoclonal gammopathies (e.g. MGUS, or monoclonal gammopathy of undetermined significance), excess light chains enter the blood stream as free light chains. The normal levels of free light chains in serum have recently been reported, along with the normal ratio of kappa free light chains to lambda free light chains. Normal levels of kappa free light chains are between 3.3 and 19.4 mg/L, while normal levels of
lambda free light chains are between 5.71 and 26.3 mg/L. The kappa/lambda ratio, which is normally between 0.26 and 1.65, is as important for diagnosis and monitoring of myeloma as are the levels of kappa and lambda light chains. As one might suspect in patients with active myeloma, the free light chain levels are higher than normal. In patients with myeloma in which only light chains are produced (Bence Jones myeloma), the type of light chain corresponding to the type of myeloma, either kappa or lambda, is present in increased amounts. But excess light chains in the serum can also occur to a greater or lesser extent with all types of myeloma, not just light chain or Bence Jones myeloma.

How is Monoclonal Protein
Normally Detected and Measured?
Monoclonal proteins can be detected and measured in both blood and urine. Serum is merely blood that has had the cells removed, leaving only the clear liquid. If multiple myeloma is suspected, your doctor will screen for abnormal monoclonal protein (M-protein) levels using a laboratory test known as protein electrophoresis. When protein electrophoresis is performed on serum samples, it is referred to as serum protein electrophoresis (SPEP), and when performed
on urine samples, it is called urine protein measure the amount of M-protein in a sample,
but cannot identify the type of M-protein in the sample. A second type of electrophoresis
test, referred to as immunofixation electrophoresis (IFE), is performed in order to identify the type of M-protein that is being produced by the myeloma cells. Typically, an SPEP is performed first, to determine if, and how much, of an M-protein is present. If the SPEP demonstrates evidence of an M-protein, an IFE will be done to determine what type of M-protein is there.
SPEP, UPEP, and IFE have both advantages and disadvantages. Among the disadvantages
is that they are relatively insensitive for the detection of free light chains, in that the free light chain level must typically be many times the normal level in order to be detected.
For instance, the normal level of one type of free light chain in blood is approximately 10
milligrams per liter (abbreviated as mg/L). However, the free light chain level in blood
would have to be at least 50 times the normal level to be detected by SPEP, and at least 15
times the normal level to be detected by IFE. An alternative test method, the serum free
light chain assay, is capable of detecting free light chains at their normal levels in blood serum. Thus, the serum free light chain assays can detect elevated levels of free light chains, even when these levels are undetectable by SPEP and IFE. This means that multiple myeloma could be detected earlier in the course of disease than is possible with either SPEP or IFE or in cases where small amounts of light chains are produced by the myeloma. The free light chain assays are best performed on serum rather than urine because of the filtering effects of the kidneys. Part of the normal function of the kidneys is to prevent losing proteins from the body into
urine. As a result, an elevated level of a protein, such as M-protein, will be present in blood serum before being present in urine. Hence, the serum free light chain assays may completely replace the 24-hour urine tests for M-protein: not only are the free light chain assays more sensitive in serum, but a 24-hour urine sample is difficult to collect and is more difficult to store than serum.

All of the above information was retrieved from:
on 11/18/2009

So, what does this all mean? I DON'T KNOW

It is a waiting game....Do I think I have cancer that has been started from the medication that they were giving me? No
Do I feel like I have cancer? NO
Do I feel like the next phone call that I am going to get is going to be a bad one all because they are trying to treat my Rheumatoid Arthritis....No

God is still in the business of keeping me calm
Just like I expect you to be because this is not bad...
I just like sharing the information that I hear and get so that If any one of you need to hear how to stay strong and positive can use me as a guide.....I am not worried.....
I am until the next one....

Please continue to pray for me and I will continue to pray for you....

I am not worried so don't you be either.....

Don't call me in a panic....because there is no reason to be.....

I feel good other than the normal day to day RA things.....


Monday, November 16, 2009

Happy Monday!

Hello everyone

How are you all doing? It is already the middle of November! Whoo-hoo!
I can't believe that next week is already Thanksgiving!

Well, with the cold weather, the hands are killing me not to mention my knees, and my feet.

The cold weather is a real nightmare for our bones (joints) and just our overall well-being.

I still have not been able to participate in my Zumba class now going on 5weeks because of the ankle sprain. Ugh!

Eventually, it will heal but goodness gracious....can it be any slower of a process?

I've started my Methotrexate shots...and now I have to fill the syringe myself...the medication is not pre-filled as it was in the Enbrel and with the Humira. So I have learned how to pull back the syringe to 60 mg and insert it into the little bottle of medication push the air into the bottle while pulling out medication with no air bubbles into the syringe.

So, do I like this process? I am sure you all know that answer....Heck NO!
I have a bruise on my right side of my stomach, two inches from my belly button for the past three weeks now! Even that takes forever to go away. As usual the shots need to be given on alternating sides and well I guess that I should just be grateful because I am still alive.

I really miss Zumba and can't wait to get back to it.
I miss my friends and the laughs that we have had.

It was my only sense of being free of Rheumatoid Arthritis if only for an hour. No matter how much I hurt afterwards, or how stiff I was the next morning...I loved going to Zumba.

Hopefully, my ankle will heal a little quicker and after some physical therapy I would be given the green light to do Zumba

Well until the next time...continue to pray for me while I continue to pray for you.

Thursday, November 12, 2009

Technology has come a long way

It's amazing that someone can type anything into a search engine on the internet and find your information.
That could be a good thing or a bad thing...Today was a good thing.
A free lance writer from Atlanta found this blog while researching information on Rheumatoid Arthritis.

Pretty cool, huh? :-)

Anyway she wanted information about the Zumba classes that I've been taking with Mary here in Moorpark.

Go figure...

I explained that although there are days when I believe that Zumba can get the best of me for not using those muscles in a long much I love Zumba and how it allows me a little bit of happiness if only for an hour a week to feel like a normal 44 year old again...You know the one, the one without the joint pains associated with RA or the one without the fatigue ...

How it allows me to hang out with my girls when they are home from college and it gives us something that breaks the barriers of age because we have a great time dancing and learning the new allows them to see their mom in a different light while allowing me to enjoy the energy that my girls bring....

I just wanted to thank Mary Jo DiLonardo for taking the time to interview me for the Arthritis Today Magazine from the Arthritis Foundation find information that may help others.

I shared with her that I was just trying to find information about RA from a real person's perspective when I began this blog. I was trying to follow some that were on the weight watchers website but no one ever really took the time to feeling somewhat alone, I began writing this blog whether anyone responded or not it allowed me to express my thoughts, feelings, fears, and successes all in one place...

Thanks to all who follow my blog for caring and sharing and calling to see how I am doing...
So until next time, I'll continue to pray for you as you pray for me....
God Bless..

Arthritis Today Magazine from the Arthritis Foundation coming out soon...