Health Update #6: Commencing Radiation

Waiting for radiation therapy to start has been a long and painful process. I'm beginning to learn ways of moving around that aren't quite so painful for my shoulder. I press my wrist to my chest with my free hand any time I stand up or sit down or roll over or walk around. I haven't quite figured out a way to use the sling so that it's effective. I finally googled some tips on getting in and out of bed and sleeping after shoulder surgery and learned that it helps to sleep on a large wedge pillow or in a recliner and have found that both help quite a bit. Still, I have to get up every 90-120 minutes to limber up a bit and take another hydrocodone. I now have a sock aid to help get dressed and am rocking the Danish fashion vibe with black lounge pants and t-shirts and clogs and cardigan.  No buttons or zippers or laces for me. 

I've been able to get a bit of emotional support through bi-weekly tele-sessions with a social worker through the cancer treatment center and I'm scheduled to meet with the coordinator of the palliative care team on May 1. At this point, it looks like emotional therapy will be particularly important, as well as pain management strategies.

The radiation session was yesterday and went about as expected. There's a bit of a gap between the information available in MyChart and the cancer center such as appointment reminders and appointment notes, so Corrine has had to do a bit of our own advocacy work over the phone confirming appointments and instructions, especially when they've only been given to me when she's not with me while I'm juiced on Norco and can't take notes with my bum arm. Luckily, we made it to the session on time. The radiation itself isn't painful, but it was quite excruciating to lie still on the table for an extended period of time during the session. I almost had to cry uncle once or twice. Next time, I'll be sure to double-dose on Norco and Ativan a half hour before the session.

Afterward, we met with the nurse coordinator to go over how things were going and after a score of "severe" (24/27) on the instrument they use to measure depression, we were told to get back in touch with my PCP to get on an anti-depressant in addition to the anti-anxiety med. Many of those negative feelings are related to the pain and debilitation. 

The oncologist looked at the CT scan from the radiation session and confirmed that I have spontaneous bone fractures in that shoulder -- a fairly common side effect of bone metastasis. That's why it's been so painful. He is referring me to an orthopedic surgeon. It will probably require surgery to stabilize the bone and lessen the pain. It might disrupt chemo/immunotherapy a bit, but hopefully not.  A follow-up X-ray this afternoon confirmed that I have a 7 cm lytic lesion in my humerus etc etc.:

There is a 7 cm (craniocaudal) permeative lytic lesion in the proximal humerus metadiaphysis at the site of FDG uptake in the comparison PET/CT with a new comminuted pathologic fracture of the surgical neck and proximal metaphysis of the humerus that demonstrates lateral displacement, anterior displacement, and slight posterior angulation. Mild glenohumeral and acromioclavicular osteoarthrosis. 

Lots of big words, but essentially, my shit's fucked up. I have a tele-health visit with the surgeon tomorrow to discuss next steps, though it looks like radiation therapy will continue as scheduled. One session down and four to go. Hopefully, we'll finally be able to address some of those issues around pain in my shoulder.

On our way home, Corrine and I stopped at a bbq place in Chase, Michigan (population 1,200). I'd driven by the sign for years and always wanted to check it out, but you can't see it off the road and the town itself is more of a crossroad on HWY 10 between Reed City and Baldwin. It was a busy place with good food and fantastic bbq.

 

On a positive note, John F. rolled in to town today to hang out for a couple days, and a few others are coming in tomorrow and next week. John and I were able to grab a couple drinks in downtown Ludington.

Corrine made flat bread pizzas for us tonight. My appetite is way down but the slice I had was delicious. I followed it up with a smoothie to try to get a few more calories and a bit of protein and fiber in me.

Looks like it's going to be a busy and soulful weekend with friends and busy week next week with more treatment.