IgG is the most common type of antibody and helps fight infections. It can be elevated due to an infection, liver disease, cancer, and autoimmune diseases.

Would see a good internal medicine doc.

https://www.webmd.com/a-to-z-guides/immunoglobulin-test#1

I agree with Kathy and others - try to see your Dr.'s back-up. With results so abnormal I am kind of surprised they didn't give your results to someone else in the office.

If this health issue persists I would suggest switching to concierge medicine. Much more personalized. We recently had a health scare that made me investigate this option - at the suggestion of several GW members. I seriously considered it but DH's health has been improving.

Sending you prayers for a good and healthy resolution.

What was the answer when you asked if there was a 'back-up' physician?

Thank you all for 'listening'.

I was unhappy to hear *nothing* from my MD to interpret the first standard blood tests she'd ordered mid-April. I waited a week, and then prompted her.

A day later she called to say that more tests were needed, and she'd see if they could be performed on the blood already drawn. Hearing nothing for six days, I prompted her again. Oh, well, no, those tests required new blood. Fine! I came in that day, May 4, for a draw. Again...nothing from her until I inquired yesterday.

The reply was as I said above -- she's had an emergency and will be gone all next week. "The doctor has your message."

Before posting here, I sent another email, basically, "Give me her backup, now."

At the end of the day, Friday, I was told that another MD in her office is her backup and has my message. My MD is an internist, in practice in this area for 30 years. Her backup is a gerontologist (20 years). They are both board certified. They both work for a hospital conglomerate in Chicagoland. This may be a better 'fit' anyway...IF I hear from him.

mdln -- Thanks for the WebMD link. I gather from the link that the IgG often fights a *recurring* infection.

I am asthmatic, but not quite COPD. I've had pneumonia twice. My current chest Xray shows some over-inflation. I am more short of breath now, and experiencing some 'brain fog' .

I had a colon resection in Oct. 2016 -- benign polyp. (Really sorry I did that; abnormal elimination since.) I have spinal stenosis and osteo-arthritis. I've had recurring sinus infections and had radical sinus surgery in 2002 . My meds are Advair 250 (for 30 years) and Tylenol #3 at night for back pain (2 years). I take 1000 units D3; nothing else. I sometimes use a lidocaine patch for the back pain.

Normal IgG range is 700 - 1600. Nobody was excited when mine was 2140 in 2015, or 2070 in 2016. Now it is 5520. IgA is 144. IgM is 36 (low on a norm of 40 - 230).

I'm losing patience over the way the entire 'investigation' is dragging out.

Such an unfortunate and inexcusable experience. Be persistent and I hope for a prompt and reassuring resolution.

When the dust clears, find another doctor and let the one you're leaving know why. To leave you hanging is an unforgivable breach of trust. Far too many physicians have a God complex and feelings of unlimited entitlement, personally I won't put up with it. To be fair, many don't. Those are the ones I look for and appreciate.

Two cynical sayings about physicians:

1. 1. Remember that half of the physicians you encounter graduated in the bottom 50% of their medical school classes.

2. What do they call medical (or dental or other health doctorate) school grads that finished in the bottom 25% of their class? Doctor.

How frustrating! I'm sorry you are having to deal with this unacceptable service. Sounds like things are back on track (or at least some sort of progress has taken place) since the follow up doctor contacted you. Hope you get answers soon and can start any necessary treatments as soon as possible. Best wishes to you.

Chisue, I’m sorry you’re going through this. My DH has Multiple Myeloma, so unfortunately, I completely understand your fears and concerns. Sadly, poorly ran clinics is becoming the new norm, I see it all the time. I hope everything turns out ok and your fears are for not, which is ok, better safe than sorry.

In my city, more and more private practices are being bought up by the local hospitals and run by them, My next door neighbor is a pediatrician and she and her partners sold their practice. They like that they no longer have to run the practice themselves - they never had any interest in business, just medicine. Unfortunately, some doctors are discovering that how they practice medicine is now being dictated to them by these hospital bean counters. The same thing happened about 15-18 years ago when large national chains started buying up veterinary practices. The vets quickly discovered that they were not able to "just practice veterinary medicine" - they were very much accountable to their owners and were being told what to do (yearly vaccinations when they knew these were not a good thing). Most had non-compete clauses that stopped them from just opening up their own practice again - often they were for 7-10 years. Many just retired early as they were not happy with the arrangement at all.

Chisue, thinking positive thoughts for you.

Why do doctors think it's okay to leave people hanging like that? Is it so commonplace to them that they forget that these are not everyday occurrences for the rest of us?

Our practice has gotten a little better in communication, but a few years back we had some humdingers trying to communicate during stressful times. Communicating with your patients need to be a priority course.

Vets who sold out to the VCAs of the world were well paid for the purchases of their practices. Contract terms and practice expectations, along with non competes, were always well disclosed in advance.. You may be describing sellers' regrets but all of them were sure to deposit the checks they got. They can't have it both ways, all were well paid to do things the buyers' way.

Not everyone has the option but I believe better doctors can more predictably be found among those affiliated as at least adjunct profs at medical schools. Many medical schools are expanding in group practices too, as are some hospital operators, and I think the quality of these isn't at the same level. Community hospitals and their groups are rarely on a par with better medical schools That's my bias but one I learned from a number of physician friends.

This morning I had a call from a woman at "The Cancer Center" at my local hospital, asking me to call to set up an appointment with a young doctor -- who I discover is board certified in internal medicine, oncology...and hospice.

I must be really slow. I hadn't made the leap from this elevated IgG to a definite cancer -- let alone to hospice. Wow.

lukkiirish -- Is there a self-help/support group online that I could access? While I dearly love the support at the KT, I don't want to bore people with this saga.

mdln -- Yes, my concern is that Northwestern Lake Forest only got up and running in March! While it's convenient should this require constant visits, I have some qualms. I'll be thinking further after I see this MD on Friday.

If I asked my related-by-marriage relative, he'd tell me to go downtown. All his brothers and several nephews were/are affiliated there. Kind of sticky if I didn't take that advice though, and I don't need 'family drama'.

Oh gosh, that's scary getting a call from a cancer center, but I would focus on the internal medicine credential only since it's a fill-in. They really should make that clear though.

My hope for you Chisue, is that the young doctor's certification of internal medicine is the reason for the referral. My mind would be going to the same place as yours. Be well.

Would not worry about the hospice certification, I see a gyne who also does OB but I am not pregnant.

Referring you to an oncologist may just be wanting to rule out the worst, first.

Lake Forest Hospital has been there for years (est. 1899), they just moved to a brand new hospital building (on the same property) in March. Lake Forest was the first hospital that Northwestern acquired in 2010. They do not hesitate to send people downtown to NMH if needed.

Glad to hear they promptly contacted you.

Chisue the summer before last my husband had a bunch of labs drawn and a chest ct scan. Several weeks later before we even spoke with the ordering doctor about the tests my husband received a call from a cancer center to come in and speak with the doctor. We went and more labs and ct scans were ordered. We were told anytime certain tests don't fall into a normal range and the person falls into a certain age bracket your referred to a cancer center.

I hope only the best for you.

Thanks, all, for your good wishes...and even *interest* in this tale!

mdln -- Lake Forest Hospital has been a second rate hospital for all of its years. People used it for the ER and uncomplicated pregnancies. It remained inferior longer than it should have while the big guys in Chicagoland fought over which one was going to get the plum location in an affluent area.

I think I expected to hear that I was being contacted by the Hematology Dept. Seems there is none -- Hematology and Oncology are 'as one' -- a presumption that every person with a blood disorder will be a cancer patient. (Maybe I'm naive -- or resistant?)

Chi -- I was referred to this doctor by my internist -- well, her backup -- because I need a hematologist to follow up on this high IgG. I just wasn't expecting the presumed lockstep to cancer/oncology. The hospice credentials added an extra *punch*.

Yes and reminds me when I was diagnoses with Lupus anticoagulant I was sent to the cancer center because that was where hemo was located.

In my experience most hematologists are also oncologists - who specialize in blood cancers. Being certified in hospice care would be a plus for his fatally ill patients. Don't read anything into it.

I got a call a few years ago from the nurse navigator from my insurance plan wanting to discuss my "cardiac disease". All I could think of, they got wind of my benign PVCs (arrhythmia) that I have been aware of since I was 19 -- over 44 years without any problem.

Chisue, Gardenweb is it for me, but with all the folks here who care about you, I seriously doubt it’s a bore for anyone responding. I know it’s hard but try to just focus on the appointment for now otherwise your mind will take you to places you don’t need to go to and that will drive you crazy.

Hemotology and Oncology are one because there are a lot of blood related cancers so it makes sense that a Hemotologist would study Oncology (and even Hospice) as well. Just because you go to see a Hemotologist/Oncologist doesn’t mean you have cancer.

The hospital that is associated with the clinic is really, at this point, irrelevant. Once you have the results then you can figure out what you need to do next whether it’s to return to your regular doctor, continue with that clinic or change clinics entirely. Your file can follow you. If you want someone to bounce your thoughts off of or to help you research things, let me know, I will be happy to help you.

Aw...you are all very kind.

I can see why doctors resisted having lab results forwarded to patients before they could interpret them for the patients. OTOH...obviously my MD required prodding.

Today's MyChart shows another test result, which seems to point to the need for a bone marrow biopsy. My kappa/lambda ratio is 37.2. (1610 kappa/43 lambda.) The norm is stated as 1.4 - 2.7. Is that even *possible*?

Then I read online that an FLC (Free Light Chain) needs to be 100 before it is considered 'serious'. These norms must be two different things.

Best I can understand it, my platelets have gotten out of proper infection-fighting mode and are replicating like Mickey Mouse and his buckets of water in "The Sorcerer's Apprentice".

Ironically, I have been feeling less fatigue than what prompted me to see my internist in the first place! That's a welcome 'up side'.

Chisue,

During the initial visit with the Oncologist we were advised that it’s really not in our best interest to surf the net for answers or education. Mainly because so much of the information is either misleading or wrong. After 7 years of this, looking back I have to say he was right. For example, did you know that results can vary (from the same sample) depending on the Lab and the formula’s they use.

If there is something more serious going on, the bloodwork is a really just a piece of the puzzle. Try not to read too much into it just yet. It’s very good that your energy is picking up.

PS: platelets are involved in blood clotting, not fighting infection. But, a high platelet count can be caused by an infection or inflammation (among a bunch of other things)

Hematologist is the one to see. My spouse has multiple myeloma and was diagnosed the day of the visit. It's been 13 years since. Lots of medicines for myeloma these days. You can live a long life with it. Best to find out soon. It does affect platelets and plasma cells in the blood.

It's amazing that we walk the earth with all that happens in our bodies.

You'll feel better when you have a diagnosis and a plan. Take care.

Susan thank you for posting. My Dh has been in his remission with MM for 6 years. You are so right. Soooo many options now

My suggestion to you would be to ask for a copy of every test you have made. Start a file with ALL test results, have that information in your hand when you visit another doctor for an opinion . Saves waiting till a report gets sent over. DH has been ill most of our marriage. Being able to provide an accurate patient history to a new practioner is a giant plus. Allows you to read over the things not in normal ranges. As Elmer pointed out, not all graduated in top half of class.

Hope you get answers quickly, and feel happy with the specialist that you choose for any treatment required.

I'm thinking about you, Sue. Hoping you get some positive answers soon.

Sending good thoughts and prayers your way.

I hope you find answers very soon (now!) Chisue, and that they can get you started on a plan to fix what ails you. It's good to know you seem like a proactive person who will find someone to help you.

Thanks, all, for the good wishes! The KT regulars have long been a wonderful support group, helping us to "Get by with a little help from (our) friends."

Susanzone5 -- Thanks for relating your DH's experience. Maybe you, lukkiirish and I will get to the point of starting an MM thread somewhere. I won't know more about my stats until Friday's consult.

I suspect both DH's were diagnosed younger than my 77.

marcopolo5 -- All of my test results are online through this hospital's MyChart portal. I hear you about copying them!

Elmer's comment is one of the reasons we 'read up'. An individual MD may even have been top-of-his-class, and he may have an outstanding record as a practicing physician -- but he also has huge caseloads.

IME, it's the staff that requires watching. My internist told me to hire an LPN as a 'sitter' following surgery to remove a staghorn calc. Hospitals boast about their excellent MDs -- but surgeons do their thing and are gone, and you're left with staffing determined by the institution's bean counters. (Back then, I was alert enough to refuse meds intended for the prostate patient in the next room. That happened twice, then I checked myself out "against medical advice" to save my life.)

I'm hoping you get answers real soon, too. This has to be weighing really heavy on you.

That would be very cool, though I’m a bit confused as to why you feel you have MM. When my DH was diagnosed at 48, so yes way too young for this disease (and sadly life altering for us), he had the most excruciating back pain, as did Tom Brokaw. I think pain is a big indicator (as opposed to fatigue). If you haven’t already, you may want to look at the LLS.org site. They have some very good information about a variety of blood diseases.

Regarding the hospitals....you are right, one does have to be very selective. My DH works for a very large hospital and refers to those bean counters all the time (and not in a good way! :c)

I'm pretty sure it is MM. My mother died of it. I have back pain (attributed to spinal stenosis two years ago). I have swollen tongue. I have extreme weight loss. I have fatigue. MY GI track has been a mess ever since I had the colon resection (benign polyp) two years ago. My hair is falling out -- which I'd attributed to the sedation for the colon surgery. And...the lab tech wrote "Monoclonal" at the end of his serum and urine test report.

I'll look at the site you linked, lukkiirish. I'm sorry this fell on your DH so *young*!

A relative was diagnosed with this about 5 years ago. He's now 94 and doing very well.

Chisue - You may be right about having MM but as others have pointed out there are many treatments available now. My Physiatrist was diagnosed with it 25 years ago and she is still going strong - and she's now 92.

As Raee pointed out Hematology and Oncology are a natural pairing and seeing a board certified Oncologist sounds like you're on the right track.

I hope Friday's appointment provides you with answers - I'll be thinking of you.

Thanks Chisue, it was life altering for both of us and my heart aches for him every day BUT...he too is still going strong, tired but strong. We went to the oncologist today actually and got the thumbs up for the next 2 months which is good news.

I’m sorry you’ve already been a member of the MM club once. It’s not a club I’d invite anyone join, but I have found the members I’ve met through the years to be warm and kind and helpful. BTW, did you know that unlike colon cancer, MM is not a cancer that is passed down through genes? It’s a cancer caused by something enviromental so there is still hope. I too will be thinking of you.

Thinking of you today Chisue. I hope that your appointment goes well and eases your mind.

DH and I met with the oncologist today. She's delightful, albeit only a teenager. haha. Seriously, she's a year or two past her fellowship at Northwestern's downtown hospital. I figure she must know all the latest about treatments.

She explained everything carefull -- even calming my Very Anxious DH. It is probable that I do have MM, but I'm still a relatively healthy 77 -- no other ailments as far as we know. I'm not anemic. My calcium is high, but not out of range. I have no known kidney or bone problems. My light chain kappa/lambda ratio is 37; high is 100.

I will have the bone marrow harvest Monday -- and turn in a 24-hour urine sample. In my future are a full body skeletal X-ray and a PET scan. They'll look for any places where I may have a cancer or other growth on my bones or in my organs and soft tissue. They will look for any genetic marker known to be involved in MM (test takes weeks for resolution).

Presuming they find no bone, organ or soft tissue problems, we have a plan.

The plan is to find drugs that will put my MM in remission. I'll start with a shot and a beer...no, no...a shot and two pills for chemotherapy. I'll go into the hospital one a week for this for...however long it takes to achieve remission.

I'm glad we liked this MD and that I decided to go with the new hospital. It's even closer than Costco! Ten minutes, door to door. Beautiful new facility.

Thanks so much for 'hanging in there' with me!

I am glad you like her-- that is so important. I am also glad that there are others here with experience with MM that can "back you up". Best wishes chisue!

Sounds like everything is proceeding positively. It helps a lot to like and trust your doctor.

You’ve been on my mind all day and I’ve been watching for you to post. I too am very glad that you liked both the physician and the facility. I’m sad to hear that they are leaning in the direction they are though. Things will be busy for a bit but at least now you’re pointed in a direction, have a plan and it also appears that you may have caught it earlier than most do. That’s a good thing. I was really surprised to see that they are going to look for a genetic marker. We’ve always been told it’s an enviromental cancer so I’m curious about that.

When my DH went through the treatments that brought him to remission, the side effects were so much better from what we were imagining they would be. Other than some fatigue, they were almost non existent and his biggest complaint was that they made him late for work. This is one disease too that is seeing a lot of new options coming to market.

Just adding: Thinking positive thoughts for you!

Fingers crossed for a great outcome to your upcoming bone marrow harvest (hope that isn't as uncomfortable as it sounds) then the xray and scan. I agree with the others, I'm glad you felt trust for the new doctor.

Thanks for the 'backup', KT Friends.

lukkiirish -- I gather that the genetic test is to see if there is something like the BRAC-A for breast cancer. (Not sure if that's the right name, but it's something used to assess which individuals are genetically predisposed to develop breast cancer.)

PKponder -- The extraction will be from my pelvis. I'm sure it will hurt like heck -- and there is *drilling* involved -- but it's supposed to take only a few minutes. They do try to numb you up a bit. I'm told I will feel like I was kicked in the back for a few days. (I'm thinking 'kicked by a horse' is most likely.) I'll probably be back here to moan and groan. Save this space.

Ahhhh....gotcha. Thanks for explaining. So far, my DH has had 3 of the bone marrow biopsies done, you are more than welcome to come moan and groan.

Chisue, I had a bone marrow extraction, which was guided by a CT scan, in February and they took 2 samples. There were 3 locals and all I felt was pressure and a nano-second of pain. Nurse held my hand so I could squeeze and she rubbed my back the whole time. Certainly not like the excruciating pain of years ago.

Just wishing you the least pain and best possible outcome...