Multiple Myeloma is a common haematological malignancy with 1467 new cases diagnosed in Australia in 2010. (AIHW 2014) It is a disorder of the plasma cells and is characterized by an accumulation of plasma cells in the bone marrow, presence of a monoclonal paraprotein in the blood and osteolytic bone lesions. It is incurable, but there are many new and effective treatments that have been developed that are increasing the life expectancy of myeloma patients, which can be upward from a median of seven years from diagnosis (Snowden et al 2011,76). A large amount of the nursing care for patients with myeloma is supportive care for symptom management, with patients experiencing many and varied problems from both the disease and its treatments.
This case study will look at a patient by the name of Mr. Smith. Through analysis of the early part of his disease, diagnosis and treatment I will demonstrate a detailed understanding of Multiple Myeloma, the current treatments, complications and nursing management.
In gaining consent for this study I asked Mr. Smith for permission to study his medical file including Doctors letters, progress notes, results of investigations and medication charts. I described to the patient that the purpose would be to write a case analysis for my university studies and that I would maintain his confidentiality by only using his age and surname. The client gave full consent stating he “would be more than happy and would give any extra information that he had if required”.
Mr. Smith is a 63-year-old male, who was diagnosed with Myeloma from an incidental finding on routine blood tests that showed high protein and globulin. This was followed up with further Immunoglobulin studies which showed an IgG Lambda Paraprotein (m-band) of 33g/L, which is an easily measurable paraprotein demonstrated in the blood of many myeloma patients and the patient and nursing staff can be educated to monitor the rise and fall of this level to assess for treatment...