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Tuesday, February 7, 2012

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. 

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