You’ll likely be referred to a specialist anyway, so if you can, be proactive and do a self referral to a hematologist/oncologist. Good luck!

Cheryl, My GP missed the signs in my bloodwork for 1-1.5 yrs, even a compressed lumbar fracture that was found because I demanded an xray after a few weeks of back pain. Finally, he sent me to a local hematologist because what should have been causing my anemia wasn't. The hematologist mentioned MM as one possible diagnosis. He didn't say it was a cancer. I went home saw what it was and decided to cold call Hillman Cancer in Pittsburgh. I prayed before I called and I got an appt with a good MM specialist within a week! I've only dealt with Hillman ever since. Research shows we get better results when we are with MM specialists and places that are experienced with MM. YOU are WORTH it! You are your own best advocate. Check with your insurance and make sure you don't need a referral. If you need a referral I would demand one from your GP. When I got to Hillman all my xrays etc had to be redone because they said the ones I had done locally were not as good/clear as they wanted. So it makes sense to get to the correct place for the testing. Good luck! You've got this.

Cheryl, it's your life and it's important to you. Find a doctor to advocate for you.
See a MM specialist. Find one somewhere and get there. Send you blood labs works ahead to them. Get a MM specialist online, maybe Mayo Clinic in Scottsdale AZ. The sooner you find out what's going on the quicker this situation can be controlled. The earlier you get treatment, if necessary, the better. Scary, yes, but could be no big deal, however, not knowing is indeed troubling. Lot of resources available and hopefully some close to you. Best of luck and my best regards.

Cheryl, I assume that you are not near a major city, but no matter what a GP is not equipped to handle MGUS, let alone SMM or MM. I found myself explaining to my PCP what MM was and having her say, "I learned that in medical school, but I truly forgot."

I am not understanding why an MRI is being ordered at this stage and why only an MRI is being ordered. Whether or not the MRI is normal is not diagnostic for MM. In my case, PET Scan, MRI, CTs and full body x-rays were all normal with no evidence of disease. Also, I have no CRAB symptoms. However, there were indications that I had MM. My M-spike was 3.1. Beta-2 was 3.4, although it did briefly go to 3.8. My IgG load was about 4,200 and the other immunoglobulins were way low. I also was positive for Bence-Jones proteins. However, the diagnosis of active MM wasn't made based on any of these tests. Even though these were not good numbers, it still could have been SMM. My MM diagnosis was based on the bone marrow biopsy, which showed that my plasma load was 70% and the FISH analysis showed troubling abnormalities. Once the biopsy results came back treatment was started almost immediately.

I also have doubts based on personal experience of the competence of ordinary hematologists. In my case, I had MGUS for 7 years prior to the MM diagnosis. I was being followed by a local hematologist and he was okay at following MGUS but not much more. In Dec. '22, he noted that I needed more careful monitoring because of poorly trending numbers, and asked that I return in 6 months to see his partner, since he was retiring. In May, though, at an unrelated checkup, another doctor decided to order some myeloma bloodwork, and the numbers were truly dreadful. (The highest number turned out to be a lab error.) I returned to the hematologist, who made me wait 3 weeks, and then said that he didn't know what it all meant but that he was confident that it meant nothing. I called MD Anderson. They asked for the test results, and after receiving the results called back and said, "We need to see you this week at clinic." The difference between the level of care, and the understanding of MM was night and day.

Cheryl, I think that everyone is telling you that you need to get to an MM specialist. It sounds like there are none near you, which is a bummer. However, it would be worth your time to travel to a major center for their opinion. I don't need a local doctor since I live near MDA, but it seems that once they make the diagnosis and determine a protocol, you can have treatments or testing done locally.

Yes! Don't wait. Find a myeloma specialist. The sooner you start care the better. This disease is simply too complicated and treatment is changing rapidly for a GP or even a general oncologist to keep up with.