(Thanks to Owen for the title. Kudos to Craig for introducing me to the films of Kang-ho Song.)
So after much effort and ado, we finally secured a copy of the January 29th CT scan reports, Wednesday morning, just prior to my appointment with my oncologist.
The Good: there are no lesions in my neck or brain. The kaleidoscope blurriness to my eyesight can, therefore, be attributed to migraine auras. For some people, they presage migraine headaches. Others (like me) get just the auras, when they experience fluctuations in blood pressure (eg due to Sutent), and/or at times they are tired or stressed. So I can gladly report I’ll remain compos mentis (or as compos mentis as I am usually) for awhile at least.
The Bad: There is a new lesion in my liver. There are also two lymph nodes in the hepatic porta (a sort of a tunnel space in the left lower liver that carries the hepatic artery) which are dead inside from cancer.
There are new lesions in my lungs in my left upper lobe (1), left lower lobe (2); and two pre-existing and previously stable lesions have increased in size. Left lower lobe nodule is now 1 cm, was 5 mm; right upper lobe nodule is now 6 mm, was 4 mm.
This news about the lungs is kind of mixed bad-and-good. The cyberknife/stereotactic radiation at Sunnybrook in October definitely stopped the growth of the right mid-lung nodule. Now I have five nodules in total. None are very large. At one point (May 2013) I had about 14-16 nodules altogether in my lungs. So it’s not the best case but not the worst case either.
The Weird: this one riles me up a bit. Regular readers may recall that I had these CT scans originally booked for Friday, January 16 (the day my right hip dramatically broke at the Y). Also, I had xrays of my right hip done on Tuesday, January 6, Friday January 16 (post-break) and pre-surgery. The CT scans were postponed to January 21, and then again to January 29, initially because the power went off at the Civic (Jan 16), and then because I was an in-patient at the General (Jan 21).
The CT scan of my abdomen and pelvis done on January 29 shows a ‘lytic metastases in the right ilium with destruction of the cortex but no soft tissue mass’. The ilium is the ‘socket’ part of the hip, the outside part of the pelvis, the bony ridge of the hip that you can feel on your side. The report doesn’t say how large it is, and the oncologist couldn’t say. [yes, this is going to be a follow-up question]. I don’t know whether it’s located in the front, side, or rear of the ilium. I don’t know whether ‘destruction of the cortex’ means the bone is completely eaten away, or partly.
My issue: On January 16, in discussion with the orthopaedic on-call surgeon, I opted for a partial hip replacement. This was based on knowing only that there was an extensive metastases in the femur, and the recommendation that to restore weightbearing, mobility, and function, this was what was required and would heal more quickly than a total hip replacement. So the surgeons replaced the socket part of the hip, and a length of the bone leading down toward the knee, the following day. Had we known there was also a met in the connecting socket, (how large? where? with what effect on function?), I feel I obviously would have opted for a full hip replacement. Had the power not gone off at the Civic that morning, the surgeons would have had access to the images (though not the radiologist’s report), disclosing the existence of this lesion. Now? surgeons are not at all interested in reopening the hip and compromising the healing to the right hip and leg.
So: I’m feeling frustrated, cross, anxious, and disempowered. None of which feels conducive to healing.
Plan B appears to be: referral back to the radiation oncologist for radiation to the hip. Some hope that the iliac met can be zapped properly in a similar way to how the lung nodule near the right side of my heart was zapped; and that the bone can grow back. Back to Sutent again (was off it to allow the wound to heal), to hopefully address the lung, lymph node, and liver nodules. Physio for my healing hip.
Meantime, I am looking forward to V-day radio with my sweetie, and a weekend visit from the Ariss-Genosko crew. I’m stubbornly still hoping to get away for a weekend with Liam while he is on his reading week break. Kevin Durant is healed and scoring 40 points a game. Liam promises to look after wheeling me around airports and for sightseeing. Seems like it may be a good distraction, the Thunder vs the Hornets. Last time we saw Durant, he did THIS for us [look for Liam at 3:35 of video, at end of 2OT] http://youtu.be/5ubc4UEU_Nk