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Multiple myeloma with acute diabetes - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Cancer
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3393 Questions
User :   When you start losing limbs to advanced diabetes is that indicative of bigger, life threatening problems?
Doctor :   Hi
User :   hello
Doctor :  
yes it indicates that the complication of the vascular system due to diabetes is in advanced stage
User :   That's kind of what I though...
User :   I'm asking in regards to my mom
User :   I have a lot of questions about her health
User :   because she won't share much w/ my sister an dI
User :   can I give you some background on her?
Doctor :   ok
User :   My mom has had diabetes for probably 20 years now. WAs controlled through diet, then oral meds, and now insulin.
User :   She also has mulitple myeloma for about 6 years
User :   She's had a bone marrow transplant once already... it came back... she tried for another in March of 08 and didn't get enough cells. They froze what they got and are trying for another.
User :   Recently she was cutting her toenails... she cut them in a way that caused an ingrown nail... she didn't notice/do anything until "it wouldn't stop bleeding" finally a neighbor looked at it and said she needed to get to a doctor immediately. The doctor has decided to remove the toe. The surgery is out a month now because of all these tests from ekg's to blood work etc. and the doctor for the toe is in touch w/ her oncologist. Is this normal or could they some how be related?
User :   the toe and the cancer and the diabetes
User :   that is
Doctor :  
due to damage to her vascular system,there is rapid detoriation of the toe
Doctor :   since the toe would lead to more complications,amputation of the toe is adviced
User :   Does it seem normal to run all these tests though prior to the amputation and to be consulting w/ her oncologist?
Doctor :   consulting a oncologist is important considering her sufferings from multiple myeloma.
Doctor :   since she had injured her toe,healing in these condition is very difficult.
User :   Do you know much about multiple myeloma?
Doctor :  
what do you mean?
User :   I mean are you very familiar w/ this particular type of cancer?
Doctor :  
i am a registered medical proffesional
Doctor :  
am aware about multiple myeloma,diabetes and the reason for he toe complications too!
User :   Ok... that makes sense. It's difficult, I live away from my mom and she just always acts like things are ok. She was saying maybe a month ago the chemo she was on was enough to keep it at bay and everything was good, but then called me a week later and said the doctor wants to do a BMT as soon as possible.
User :   My sister sees her often and tells me that her skin is very weak and that she had had a rash which she had itched excessively and caused massive bruising on her arms from the scratching. I guess I just feel like her time is limited based on all these things/signs, but she won't communicate any of that. What are signs we need to be aware of that could indicate that she might be close to dying. I ask because she is alone, our father passed away already and I want to be able to be prepared to get to her in that event
Doctor :  
MM is the cancer of the white blood cells
Doctor :  
it is a detoriating conditon
Doctor :  
and it manifests systemic symptoms which are difficult to diagnose.
Doctor :   Myeloma is generally thought to be incurable, but remissions may be induced with steroids,chemotherapy and cell transplant.
Doctor :  
Bone pain, susceptible to infection,renal failure,anaemia,neurological manifestations are the major signs and symptoms.
User :   Other then her broken bones, are there other signs to be on the look out to indicate advancement of that. Does having a combination of advanced diabetes and myeloma put extra stress on her health systems...
User :   funny you mention nuerological symptoms. She's been kinda nuts over the past few years, we always called it "chemo brain"
Doctor :  
Neurological symptoms are weaknes,confusion,fatigue,visual changes,retinopathy,headache etc.
User :   Lots of that. She has a lot of that.
User :   confustion, weakness etc
Doctor :  
diabetes is also a systemic illness, so the combination of these do have a extra debilitating effect on her body.
User :   how long can a body fight these conditions? Would it make sense there has been rising concern over her heart functions as well?
Doctor :  
there is no exact specification over the time span, it will depend on the progress of the disease.
User :   Yes, I guess that makes sense. All I can say is it is very concerning. she's broken all 4 of her limbs and had titanium rods inplanted in 3. My biggest fear is that when they go to do a transplant for her again they will not harvest enough cells once again. I also must say the amputation of the toe leaves a very "creepy" feeling in my mind that makes me think time is ticking.
Doctor :   well it is to be done to avoid complications.
Doctor :  
as you know,cancer in any form is threatening.

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