PVNS Radiation Treatment 9

The radiation treatment is becoming more difficult with each session because the damage that it causes is cumulative. I've ceased making progress with my physical therapy and range of motion because of all the swelling caused by radiation. I'm walking faster but much more still then I was at one week out of surgery.  There is a slight burning sensation inside of my knee and on the skin. The swelling is causing much pain that feels like a vice grip is tightening every time I bend my knee. The level of pain has been a steady 3-4 and the fatigue is horrible. You may ask is it worth it. I believe that I am very fortunate to have a husband that says take care of your health first and concentrate on getting better. He knows I am anxious to return to work. Yes it is worth having my chances of recurrance drop from nearly 59% to 10%.     Everything has it's risks but each individual needs to access them and apply the risks to their own situation.

I saw my oncology radiologist after my 10th RT session today. I'm experiencing to much swelling and pain in my knee. I have to stop physical therapy until the inflammation settles down and I can't put any weight on it at all. Ice, elevate and wrap it in an ace bandage. She's concerned about infection and if I'm not much better by Thursday she will send me back to surgeon to have fluid extracted. I'm so tired of being in pain, feeling ill and being concerned by such a slow recovery. Surgery was Dec 14th and range of motion remains at my pre radiation point of 84 degrees, well at least I haven't lost more range. I'm starting to go psycho and need to return to work.

PVNS,1/2 way Through with Radiation Treatment Side Effects

Radiation treatment is proceeding well. It's Monday morning and I just received my 9th treatment...only 12 more remaining. I'm beginning to feel the cumulative effects. There is slight swelling, stiffness and it feels like someone has bashed my knee with a hammer. The new sensation that I'm feeling is a slight burning and the skin is becoming quite sensitive. The pain level remains 2-3 and I continue to elevate and ice my knee which helps. The fatigue continues to worsen but I am learning that I just need to push through it and remain as active as possible. If I sit over a half an hour my knee stiffens up and becomes quite painful. My range of motion in the knee remains at 84% which is what it was on February 7th prior to starting RT. At least I haven't lost and range of motion.

This whole PVNS journey has been quite challenging. The thought keeps crossing my mind "will my knee ever feel normal again and will my range of motion return?" Surgery on any joint frightens me because I know from experience that once a joint is disrupted by surgery it is never the same. The damage continues to cumulate with each surgery. It's a mental game of keeping your attitude in check and not having too many pity parties.

6 out of 20 Sessions Radiation Therapy

Feels like I'm at deaths door.

It's now 12:30 a.m. and I'm still away from the pain. I saw the radiation doctor today and was told I would be seeing her once a week until the end of treatment. I saw pictures of how they painted the 3D image of my knee to differential what areas and how much radiation would be given. It was kind of neat to see exactly what areas are getting zapped. I told him that I'm experiencing fatigue, swelling of the knee and increased pain from the treatment. He said that all of that was normal. I asked how the radiation helped and he explained that healthy cells have a much greater ability to regenerate compared to the proliferating cells (the bad ones). Essentially they sterilize the DNA in the unhealthy cells so they can't reproduce. I also asked why so much pain. He explained that each time I receive RT it's causing tissue damage which is an injury and it accumulates with each RT which causes swelling and pain just like surgery. It takes my body a lot of energy to repair the damage and that can be the cause for the fatigue. Since I wasn't feeling well prior to RT the fatigue and all of my other symptoms are exponentiated and it's kicking my butt. So another night of not sleeping well due to pain but I can't take more pain medication because right now it's making me feel ill. I'm putting to use every mental skill that I have in order to keep smiling through each day. I hate for Steve to see me cry but sometimes I hurt so bad the tears just run down my cheeks. He is so sweet and supportive but I feel like a bum not working...It's just not a good feeling.

PVNS Radiation Therapy Procedure and Room

This is the room in which I receive my treatments in and the blue device is the mold that they made to immobilize me knee during therapy. I received my 4th radiation treatment out of 20 today. After 3 treatments I've been set back 2 weeks in recovery. I'll get my range of motion measured again tomorrow. Crossing my fingers I haven't lost much range since it's not fabulous to begin with. I'm also feeling even more fatigued even though I was hoping it wouldn't have that effect. My pain levels are at a pretty steady 3 and I rarely have to take any medication. The worse part is having to drive downtown during rush hour every day. That in itself wears me out.

I lay on the table and place my left leg into the mold and then the techs line up the green lasers and match them with my tattoos. The overhanging pert of the machine rotates to the left, they put a filter on the machine (a sliding plate that helps to direct the radiation) they then exit. The steady high pitched beep blares when I'm being radiated and lasts about 1 1/2 minutes. Then the it rotates to the top, beeps then rotates to the right side and beeps. I lay there thinking my cells are getting destroyed and I'm just laying here. There is something that feels real wrong about the whole process. I'm scared to death that a muscle will spasm and cause a slight motion spraying the radiation all over. Of course that doesn't happen but it's still a fear. Then I get up and tell the gals "see you tomorrow same place same time I'll bring the drinks from the lobby."

7 Weeks Post-Op, Range at 84 Degrees

I thought radiation therapy would be simple but it's much more involved then I had imagined. I had my first appointment with the radiology oncologist three weeks ago. At that time it was decided that Rt would be a god choice for me. I was told that they could decrease my chances of recurrance from 40% down to 10-20%. "Sold!" Then I had to wait a week for my insurance to give approval. Tick tick tick, time is a wasting. Another week just to get my CT, tattoo and the mold to hold my knee so they could line me up in the exact same position every time. Then of course another week trying to get my mri done. First appointment oops you need the steroid prep. Second appointment the wrong knee was scanned. Third appointment was cancelled due to a reaction to the prep and finally my fourth appointment was successful. Today is my final set up appointment prior to actually getting the RT. In the end they decided not to use the gadalinium.  They where able to get the pictures without it. My final appointment before radiation therapy.Pain level has spiked to 3-4 in the knee and the last 2 weeks my good knee has been hurting on the medial side. I’m sure that’s it’s just due to my gait being off but it’s normal to wonder if pvns is in other joints when they start hurting. It’s sad to say but I’m not sure which knee hurts worse. I continue to be more and more active and I’m sure that’s adding to the swelling and discomfort.

I finally saw my pain management doctor and went over the mri results. There is bulging out of the majority of my discs, cord flattening and a couple tears in the lamina a lot of degenerative changes. The doc asked “what type of stuff have you done in your life?” “We see this kind of spine in horseback riders (rodeo) and jumpers. Yup I’ve done dressage (dancing horses to music) and occasionally jumped horses but no rodeo. She said that nothing jumps out as the culprit of the back pain but any of it could be irritating the surrounding tissue causing pain but she honestly doesn’t know. She offered a couple choices. She increased my Baclophen pump meds by 40% today and told me to call if that doesn’t help and she will increase the Bupivicain when I get my pump filled in a month. She also offered epidural shots if this doesn’t work. After my sleepless night due to pain at least I feel like there may be some hope of not constant being in pain, She seemed more concerned about my chest CT then anything else. “You know what this said, right? and when is the next CT?” It’s unsettling to know that there is something in your lungs, developing and involving lymph nodes and you just have to wait until it is developed enough to be diagnosed or it will disappear, Two more months until my next chest CT until then my plate is full and I have to concentrate on swallowing the morsels before me, without choking.

i spoke with my primary physician and he completely understood why I am switching to a new doctor. Being an hour away is causing me not to see the doctor when I need to see him most. I’m anxious about meeting a new primary care physician today, since my medical history is so long and complicated. I hope that he will be able to figure out why I am feeling so horrible. I know that they need to check my hormones and adrenal gland function since my other blood work has come back good. I hate to even think it but I am 47 and had a hysterectomy which can cause menopause to begin earlier then usual.

I found this article about how they paint the area in which the radiation is going to treat. http://www.hyscience.com/archives/2005/11/sensors_a_smart.php  IMRT developed about 10-years ago, works by 'painting' small areas of different intensity radiation over the tumour. It involves the use of a servo-controlled device called a multi-leaf collimator, that has about eighty "moving fingers" that can "allow or stop" the radiation from the treatment machine reaching the patient. It's precise control allows a three dimensional pattern of dose to be scaled up. By painting the dose distribution in this manner, a high tumour-killing radiation dose is conformed to the tumour while an acceptably low and safe radiation dose goes to the surrounding tissues and vital organs. This is very different from conventional radiotherapy in which no such painting is done and the high dose can extend beyond the tumour and damage healthy tissue.Intensity Modulated Radiotherapy (IMRT), is a radiation therapy for cancers that improves clinical outcomes by a providing more accurate targeting of tumours then with standard radiotherapy, and minimising the amount of radiation absorbed by healthy tissues. The good news about IMRT is that it results in patients only receiving a high radiation dose where they need it, thereby preserving healthy tissues.