MPNU

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Misty-3
Posts: 17
Joined: Fri May 31, 2019 5:04 pm

MPNU

Post by Misty-3 »

Hi all

Just recently joined in. Thanks Steven.

I have just been diagnosed with MPN. At first my Haema thought ET but after BMB, it is now unclassified. My blood platelets were increasing every time I had my routine blood test so the trip to the Haematologist and the findings. On aspirin 2/day...Hydro or injection but I was very hesitant 😕 until second opinion.

Just saw another Haema Dr Ian Bilmon and he seemed to be very confident explaining about this condition. Had another blood test and will see him again after 2 months (and to do another blood test before seeing him). For comparison I suppose. He has not given me any drug yet for now.

My symptoms include tiredness and tinnitus and sometimes heartburn. Have changed my diet to fish, veggies and fruits. I do eat brown rice...

It’s great to have this forum here in Australia!!
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MPN-MATE Admin
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Re: MPNU

Post by MPN-MATE Admin »

Hey Misty... :D

Welcome again to MATEs FORUM... Very cool to see you here too... 8-)
Hopefully other members will welcome you also now that you have made your first Post etc.

Your MPN Unclassified sounds interesting.

You report that your Platelets are rising steadily but have not mentioned anything else concerning your Blood Test results, as yet (?)

Based on that alone, and some of the symptoms that you are reporting on... It sounds like you might have Essential Thrombocythaemia (ET), as Rising Platelets seem to be prevalent in your case...

The fact that not much is showing from your Bone Marrow Biopsy (BMB), could be a good thing in that there does not appear to be any signs of bone marrow scarring, (based upon what you have said). This might also mean that your MPN condition has been detected very early... :-)

When I was first diagnosed (3 years ago), I commenced by recording and keeping all of my tests results whatever test that might have been. In this way, I am always better aware of my risk factors, at any given time... My first BMB I was Grade2 level of fibrosis, and my Platelets were at 1.7Million... I was also initially diagnosed as ET.

As a result, I have managed to teach myself, (with the help of others), a little more about my Blood Tests and what they might imply, in a general sense only of course, as I am not medically trained at all...

However, if you were to read through the information pages about MPNs, (MPNs What Are They?), and the three more classic types of MPN conditions, you too will soon glean that each of them is just a little bit different even though the symptoms may be somewhat the same, and that different blood cells, (Red, White or Platelet), can be more active in one MPN condition over that of another etc.

https://www.mpn-mate.com/mpns-what-are-they/

Misty, I do not wish to alarm you in any way because your doctors do not seem too concerned right now. However, 'Tinitus' was/is for me an indicator that I was or might be about to have what is called a Transient Ischaemic attack (TIA).

https://strokefoundation.org.au/About-S ... Attack-TIA

Please do not be too alarmed right now, as my platelets are often over 900s, however, both my previous two (2) TIAs were when my Platelets were well over the 1Million marker... So I don't think you are quite there just yet... Nevertheless, it might be worth mentioning that 'Tinitus' is an early warning sign, in some cases, to your medical team, and see what they say etc...

Anyways... I shall look forward to speaking with you more over time... Welcome again Misty... :-)

Steven
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Misty-3
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Joined: Fri May 31, 2019 5:04 pm

Re: MPNU

Post by Misty-3 »

Thanks again Steven.

I have mentioned tinnitus to my Haema (both the previous and the current one I have) but they haven’t said anything about it. But I will ask again in my next visit.
I think I have slight characteristics of all MPN types and that is why they put me under unclassified. My last platelet count was 599. My BMB has so many medical terms that I don’t understand. Everything is so bizarre and overwhelming...
I’m on diet at the moment and I’m using aloe vera for detoxing... I used to drink coffee at least once a day but stopped when I started my diet and detox since March. Coffee would be nice but wait a little when I finished my self starving. I love my food and I used to eat unhealthily...
I think stress is also a factor. I haven’t been so stressed 😥 at work in my life than the last year that passed. It was building up that I wasn’t able to slow down. Wake up call I suppose.
BTW my new Haema is Dr Ian Bilmon do you by any chance heard of him? Who’s your Haema?
Oh, my name is Linda and Misty is just a name that I like...
Talk to you again soon!
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Re: MPNU

Post by MPN-MATE Admin »

Hey Linda... :-)

No, I cannot say that I am aware of your doctor at this stage. Which oncology/haematology department is he attached to?
I Googled him and he seems to be at Wahroonga and Westmead. I am based in the Hills and my doctor also treats at Westmead.
Having said that, however, very few doctors in Australia, are actually MPN Specialists, with a few exceptions...

Hopefully, our Fundraiser and Awareness campaign might eventually help change some of that... one hopes... ;-)

When I had my last TIA, the very first thing I noticed was the Tinitus slowing building in my ear (Left). It gradually increased and rose to a crescendo then there was like a slap/shock... At that juncture, I lost the use of my right arm, my vision became monocular with little white lights in my periphery, and my speech became slurred... I recall feeling like I was trapped inside my body, like it was some kind of vehicle... It was a strange sensation, an out-of-body experience I guess you could say...

That is why I have mentioned Tinitus to you, irrespective of what others might have to say... I am now able to be aware of my platelets on the rise, via the presence of my Tinitus... which tends to be present whenever they are elevated etc.

Hence, all I am really saying is that it is worth keeping an eye on them, from time to time... Please do not become overly anxious about it Linda, because your platelets are well below where mine were at the time of my TIAs etc...

Yes, I also understand that this diagnosis can be overwhelming for all of us in the first instance... However, usually once we know a little more about our own individual MPN, and come to understand how the treatment, (medical regime), we are having is helping to manage our out-of-control blood cells... We eventually can realise an almost normal existence again... almost... ;-)

(Fatigue is unfortunately a terrible constant for most of us...)

For ALL of us that is more or less true... All of us have a slightly different MPN, and at the same time, our symptoms are very often very similar too... So usually a FORUM like this one can become quite a useful tool...

Personally, I do find it quite a comfort to realise that other people know and understand what I am going through...

Linda, Garry and I usually arrange a cafe catch-up every so often... Generally around Parramatta just because it seems reasonably central for most... Some times only Garry and I turn up but it matters not...

Linda, if you come along to the next one I can try to explain to you a little about what our blood results generally tend to indicate...
I will simply print off my last Full Blood Count, (FBC), and run through each of the indices with you etc.

However, no single blood test should ever be considered in isolation, but rather seen as a trending event. Presently, my FBC I arrange every 6 weeks. I collect all my test results just so I have an idea of what is going on... For me? I found that comforting. Others prefer just for the medical teams to advise them etc... We are all different, and what one person wants or needs varies of course... In the end, all that matters is what works best for you...

As to some of the medical MPN jargon that is used, I have also tried to list some more common terms on our Glossary page, that might help you a little: https://www.mpn-mate.com/mpn-glossary/

Anyways, should you want to do the cafe catch-up sometime just let me know, and I will private message (PM) you my contact details or send you an email, whichever you prefer...

Stay happy & well Linda... :-)

Steven
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Merry
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Re: MPNU

Post by Merry »

Hi Misty

Welcome to the forum! It’s great to hear from you. Hopefully we will build a helpful, supportive community here where people can come to share their experiences.

I haven’t suffered from tinnitus with my ET but am certainly fatigued and have a host of other symptoms which may or may not be MPN related.

I hope your docs come up with some answers for you soon. My platelets came down rapidly after starting Hydrea although they were not that high to begin with. Have you had all the tests for JAK2 or Calr etc?

Take care, Merry
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Hethro
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Welcome

Post by Hethro »

Hi Misty
Great to hear from you and a very warm welcome...... There are many challenges those with an MPN have but work with your Doctor and don't be afraid to ask as many questions as you can when you next see Dr Bilmon
We are all here as a backstop for each other when things get a little tough and they certainly can at times.
Take care
Garry
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Misty-3
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Joined: Fri May 31, 2019 5:04 pm

Re: MPNU

Post by Misty-3 »

Hi Merry, Stephen and Gary
Thanks for the welcome...
Working 5 days a week at the moment but I will try to catch up with you...
I’m JAK2+ Confirmed by BMB...
I haven’t heard CALr...what is it?
Just had blood test and waiting for results.. will see the specialist early August. Will do another blood test again before seeing him. Thanks again and take care everyone!!!
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Re: MPNU

Post by MPN-MATE Admin »

Hi again Linda...

CALR is short for Calreticulin.

"The CALR gene provides instructions for making a multi-functional protein called calreticulin. This protein is found in several parts of the cell, including inside a structure called the endoplasmic reticulum (ER), in the fluid-filled space inside the cell (the cytoplasm), and at the outer surface of the cell. The ER is involved in protein processing and transport, and within this structure, calreticulin plays a role in ensuring the proper folding of newly formed proteins. The ER is also a storage location for charged calcium atoms (calcium ions), and calreticulin is involved in maintaining the correct levels of calcium ions in this structure. Through calcium regulation and other mechanisms, calreticulin is thought to play a role in the control of gene activity, cell growth and division (proliferation) and movement (migration), the attachment of cells to one another (adhesion), and regulation of programmed cell death (apoptosis). The function of this protein is important for immune system function and wound healing."

https://ghr.nlm.nih.gov/gene/CALR

Basically, with all of the MPN 'Driver Mutations' they each act on what is called the 'JAK STAT Pathway'. The JAK2 V617F mutation, was discovered in 2005, and is present in 90 percent of patients with polycythemia vera (PV) and in approximately 50 percent of patients with essential thrombocythemia (ET) and primary myelofibrosis (PMF).

"It has taken almost a decade to identify most of the somatic mutations that govern JAK2 V617F–negative MPNs, including JAK2 exon 12 mutations in PV7 and thrombopoietin receptor (MPL) mutations ET and PMF.8 More recently, two groups identified recurrent mutations in the calreticulin (CALR) gene in the majority of JAK2/MPL–wild-type MPN patients"

When one's blood is being assayed, the presence of anyone of the known three (3) basic types of 'Driver mutations helps to diagnose which MPN that one might have. The three (3) known types are:

* JAK 2
** MPL
*** CALR – Types 1 & 2

When a person is diagnosed with an MPN, without anyone of the three (3) basic 'Driver' mutations, they are said to be Triple Negative.

However, the discovery of the JAK-STAT signalling pathway has since led to many new drugs and treatments for people with MPNs...

Hope this helps...

Steven
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