You may recall back in November/December I shared that my humerus bone in my left arm was at high risk for fracture. The debate at the time was surgery to reinforce the bone, or to try radiation to kill the cancer cells. We went with radiation and I had 10 total treatments. At that time I didn’t have any pain or discomfort in the arm at all. About two months ago I noticed some swelling in my bicep, decreased range of motion and pain. The pain starts at the top of the bone and goes down to a little above the elbow with the worst on the high side of the bone where the humerus and the shoulder connect. The scans and x-rays began, which showed fluid build-up and a cancerous lesion that is growing out of the bone. The tumor that is growing outside the bone is what’s causing all the pain right now. I call it the “snuggle zone” for Charlotte. Her head is right at that level when we are snuggling on the couch and she bumps it on a daily basis. Ouch!!!! She has started to ask about my “bad arm” before she sits down with me which helps negate some of the bumps. It’s also the same arm that is typically use to carry things since my mastectomy back I 2012. The right side had the original surgery for lymph nodes dissection (preventing lymphedema has always been a focus for me). I also use it to push myself out of the car when I am parked and the same side I get blood pressure taken on. It’s hard to tell what the true pain level is at this point. I am still on a pain patch and we recently went from 75mg down to 62mg so it’s probably causing more pain then I recognize at this point. The pain patch is for the cancer in the lower lumbar spine that was causing so much pain this time last year. We are slowly weaning down the patch but I may never be total free of constant long term pain management at this point. I have been doing some lymphatic massaging which has helped some of the swelling go down in the arm.
I consulted with radiation oncology and she referred me over to orthopedic surgery for further evaluation. Unfortunately more radiation isn’t an option and it’s possible this treatment could have caused this to happen. Radiation can cause cancer (one of the risks you take) and with no symptoms or pain prior to the treatments it could have contributed to or not been effective in this current situation. With that being said, radiation has been very effective for me in other areas along the spine and brain and has really helped with pain mgmt.
Last week Steve and I met with the ortho surgeon who was very nice and patient with us. Yet another doctor who has been added to my team. I have lost count of how many doctors I have seen and consulted with at this point. The surgery itself isn’t super invasive which is good. They would go in and scrape out all the cancer, fill in the hole from the tumor removal and fortify the entire bone with a rod from shoulder to elbow. Recovery didn’t sound bad either and basically I should be able to apply weight pretty much right away. I have wanted to start yoga or some light weight training which is delayed by the fracture risk. I can’t put my full body weight on that arm. The surgery would be the same if I do end up fracturing or breaking this bone prior to surgery, there would just be more clean up needed on the bone or muscles depending on how it breaks.
Basically we need to weight the pros and cons of the timing. This surgery is needed but with chemo working is now the time to take a break necessary to allow for surgery? That is the question! It will come down to how long and how much pain can I tolerate until I can have a chemo vacation. Ideally it would be nice to get through summer and fall before surgery. https://www.knowyourbody.net/humerus-bone.html
Never a dull moment in the life of stage 4 cancer that’s for sure. Even when things are going well on one hand there are most likely other things that are not be going so well on the other. We are happy with the results of chemo and it’s unfortunate we have to deal with another surgery and another issue. Thank goodness for amazing physicians and surgeons we have so close at Johns Hopkins. The collaboration and consulting between all those on my team happens behind the scenes and is quickly and effectively done.
One other topic I just want to clarify for my readers. Although the pet scan from my last post did show less lesions in the spine there were still too many to quantify. The bones don’t show up great on a PET scan so it’s hard to tell how they are responding if at all to the chemo. Radiation and vertebroplasty has been done to various parts of the spine which is what we attribute the reduction of lesions and pain to. “Too many to quantify” is still pretty extreme in terms of how advanced this cancer is throughout the bones.
I hope everyone has an amazing weekend, love to you all!
No comments:
Post a Comment