[NP-Clinical] Need help

[Julie Orfirer]

So, this is why you aren't supposed to see your friends as patients.
   
  My husband's best friend, our best man at our wedding, was over a few weeks ago and said he was diagnosed with osteoporosis but had to wait several months to get an appointment with the endo that his doc suggested he see.  I said, well, you can come to our office and figured he'd see someone else in the office and not me (due to being a friend and some recent personal issues that were sort of between the two of us - way too complicated to discuss).  But, there he was on my schedule.  I figured, what could go wrong?  So I did all the routine stuff and included a monoclonal protein study  which I do for just about anyone in their 60's and he had had prostate cancer 2 years ago.
   
  Just got the report back.  Bad news.  He has an "M-spike in gamma region", "monclonal IgG kappa C/W MGUS, early myeloma, amyloidosis, etc".  I admit that I don't really have a clue whtat all that means chemically but I know what it means clinically.  In fact, just had my first case of multiple myeloma yesterday - got the report from the heme/onc of another man who had the same results - his x-rays look terrible.  So that's why I'm so running to that conclusion.
   
  He has an appointment for next week - I don't know what to do.  I don't know if I can tell him about this or if I should or if I should switch him to my boss's schedule or see him together with her or what.  I don't know how to keep this a secret from my husband until then.  I was just telling him last night about my other patient whose x-rays were filled with lytic metastatic lesions.   I'm really torn up.  (Just drying my eyes now from reading the report.)  His 70th birthday is in a month.  I know that people live well for a long time with MM. But....
   
  Would appreciate anyone's opinions, advice.
   
  Julie


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