Polyneuropathy and MGUS
 

Hi, all.

Recently, on another thread, I told you all that I have axonal sensory motor polyneuropathy, and that my blood work showed an M spike for monoclonal gammopathy. Well, I saw the hematologist/oncologist yesterday for what my neurologist said would be a round of bone scans, 24-hour urinalysis, more blood work, etc. So, that was what I was expecting. But, after hearing my polyneuropathy diagnosis coupled with the pain I've been experiencing in my shoulder, arms, and wrists (not all at one time), he thought it was best to go ahead and do a bone marrow biopsy. Boy, that threw me for a loop! I was totally unprepared to hear that. I will be given Antivan, and then something local for pain. Is there anything else I can take for pain? (I'm not too good at coping with pain.) He wants to rule out Multiple Myeloma, as well as see if he can figure a way to help with the neuropathy. I was so shocked I was out of it, but I think I got that info right. Am I right to be fairly concerned?

Yes, I'd be concerned too. But perhaps your doctor just wants to cut to the chase, for your sake. This might be because of your symptoms and intensity.

If they do this on the hip? Ask to make sure they don't hit
that nerve...that goes near that area called the Lateral femoral sensory nerve. Some people who have bone grafts or biopsies there may develop meralgia paresthetica if the needle hits that
nerve.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195663/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686059/

I had damage to the right LFSN from my c-section which was
also a laparotomy looking for an ovarian tumor. I had a complex high risk pregnancy with elevated hormones making my blood pressure critically high...but no tumor was found. The search for it however, compressed my LFSN and I had years of grief from that.(until Lidoderm patches hit the shelves, and I used those to put the nerve into remission).

So discussion of the technique and risks would be a good idea with your doctor.

Personally, I'd be concerned if a doctor opted for a profoundly invasive procedure before ANY basic x-rays, scans, labs, etc are done.

Thanks, Mrs. D and en bloc.

I was in such shock on Wednesday that I failed to ask many questions. I just was unprepared for a biopsy. En bloc, I did ask the doctor why not the other tests first, and he said because of the pain I've been experiencing in my left shoulder, elbows, forearms and wrists. The pain is not all at the same time, not too bad, but every day. He also mentioned that he was concerned about the level of neuropathy I have, in addition to the arm pain. I have axonal sensory motor polyneuropathy, which is all new to me. I knew I had peripheral neuropathy seven or eight years ago, and I quit seeing a neurologist then. Just continued taking Gabapentin for the vibration/low level pain. My new neurologist thought I'd waited a sufficient time, allowing for the nerve conduction, EMG tests to be clearer. This all started with vision issues.

Mrs. D., I am calling them this morning because, in addition to these other concerns, I have had a number of episodes of shingles in that general area. In fact, for the past two years, I've taken acyclovir year-round, keeping it under complete control.

Thank you both for your input. I am thinking this through.