Wednesday, December 17, 2008

Diagnosis

Many of you know this already...but I've got some catching up to do for those who don't and if I'm going to do this blog thing right, I better start from the beginning.

One of the less valuable cards in the genetic hand I was dealt is high cholesterol. I'd battled this over time through exercise (long-since given up, sadly, mostly as a result of my work hours) and diet, but my primary physician Dr. PZ had advised that if I wasn't able to control the cholesterol through these measures, medication would be needed. I was able to bring up my HDL (the "good" cholesterol) through exercise and control my triglycerides through diet, but the LDL ("bad" cholesterol) kept increasing until it got out of hand. Around 2006 after my total cholesterol was close to breaking the 300 barrier, we decided it was high time to go on medication. My medication, Lipitor, did an excellent job of bringing my total cholesterol down to under 200 (it was 165 the last time I had it checked). All was well.

In addition to this suspect genealogical trait, I also inherited from my parents the fortunate geography of my birth, a city very close to California's wine country. Over time, with rising income and the influence of my wine-loving brothers (one of whom is an avid collector) I've become quite a wine aficionado myself, and at this time I've got a fairly formidable collection. I would never stoop to collecting for investment's sake...that is, I drink the stuff! Not to excess, but enough where, in combination with the Lipitor, it's prudent to check liver levels as Lipitor works by inhibiting some liver functions (the liver is what creates cholesterol in the bloodstream).

Dr. PZ ran an ordinary blood panel on my liver in October, 2008. And he noticed something odd: a spike in my protein levels. I went back to the office and ran another blood test to confirm it, and it was still there.

Dr. PZ advised me that I had what is called a "monocolonal spike" -- which is to say a particular protein was observed in an analysis of my blood and that protein didn't belong there. He told me of two potential conditions, which I initially believed were separate conditions but which I now believe to be related.

The first of these conditions is called MGUS ("em-gus"), which is short for "monoclonal gammopathy of undetermined significance." This means, essentially, that nobody knows why the protein is there, but it's not a big deal and just needs to be monitored. There is a 4-10% chance that, at some point in a person's life, MGUS would lead to the second condition, but most people live "for decades" without issues.

The second condition is Multiple Myeloma, which Dr. PZ described in non-fatalistic terms (he's a very non-alarmist guy) as a "malignancy of blood plasma cells." He didn't opine further, even when I told him that "anything that ends in 'oma' sounds really bad.

Both these conditions, I was told, are quite rare in someone of my age.

Dr. PZ referred me to a hematologist / oncologist, Dr. SH. PZ, who I trust completely, said there are other good ones, but SH is the best he knows. So a few days later, I went to see Dr. SH. But before that, I did a little research on what Multiple Myeloma (MM) is (this will be the next blog entry).

Oh...and for anyone concerned about red wine intake, it's been shown in some trials to be beneficial vis-a-vis myeloma.

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