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Showing posts with label preparing for surgery. Show all posts
Showing posts with label preparing for surgery. Show all posts

Wednesday, October 3, 2012

Building Resistance to PVNS Tumors



{Correction 02/13/2013): 6 mo f/u MRI 06/2012 showed a false pvns recurrence. It was proven during f/u surgery 12/14/2012that the mri was showing scar tissue and not pvns. After you have surgery the mris become more difficult to read accurately. After the 6 mo f/u mri I had two more mris done showing that the (false) pvns was remaining stable (unchanged) that was the clue that it was scar tissue and not pvns.} The tests that I referred to in this article all came back good. I do not have an over or under active immune system nor anything besides osteoarthritis from age and pvns.

Being a Pioneer

I am well aware that we are all guinea pigs and it doesn’t matter what treatment we choose. On a positive note the more data that is collected increases the chances that a common link could be found. I commend everyone who is willing to try adjuvant treatments because you are the pioneers that may someday make a cure possible. Note please make sure your physicians are sharing your information (positive and negative) with researchers and not just keeping it in their private files. 


MRI Report of  a False PVNS Recurrence

Why did my treatment regimen fail when others (approx. 80%) with the same amount of PVNS, damage and treatment remain in remission? During surgery the joint was visualized arthroscopically then an open complete synovectomy was done. My orthopedic oncologist is a top rated surgeon familiar with pvns. She removed all visible signs and areas that showed on the mri. I followed up with 18 treatments of 200 greys each which would have disabled . My six month follow up mri showed a new area of recurrence. Something is making my body more susceptible to the pvns and until that is corrected I’m afraid it will continue to recur, destroy my joint as it has caused the chondromalacia to worsen in just one year even with surgery. 

The cellular composition of diffuse pvns is exactly the same in each individual so this means that pvns itself has the same strength and destructive properties in everyone. What makes some bodies more susceptible to a recurrence? I have arthritis in both knees and throughout my spine that is well out of proportion to my age and lifestyle. 
I’m working with a research arthritis specialist who is running many tests to see if I have some type of defect that makes me more susceptible to arthritis and or pvns. I am also working with an immunologist who is checking to see if there is a link via the immune system. some of these blood test take a month to get the results so I will post any information that they may provide. For now the doctors are trying to build up my body as much as possible immunologically by addressing my allergies (they have already done allergy testing for which are minimal), with diet (I’m looking into cancer diets), and supplements including Vit D because it was very low and low vitamin has connections to tumor growth. Hopefully along with what they find out from the blood tests I will be in better shape to resist future tumors (recurrence) after my next surgery. 


I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.


Friday, August 24, 2012

PVNS Questions to Ask Your Doctor


Questions to Ask at  your PVND Doctors Appointment:

  • What type of experience do you have with PVNS? diffuse, nodular, open/arthro, clinical trials
  • What type of PVNS do I have? diffuse, nodular, mixed, intra-articular, extra-articular
  • When will biopsy be taken, how long for the results and will surgery be done at that time? 
  • How has this disease affected my joint? what damage is the mri showing if any?
  • What are my treatment choices and which is the best treatment for this type of PVNS?
  • Do you prefer open vs arthroscopic surgery and why? How many have you done? Outcomes?
  • Will I be given a nerve block along with general anesthesia?
  • Do you use staples or sutures to close the incision and why?
  • Knee joint: will a continuous passive movement machine be available after surgery? 
  • How long will I be in the hospital?
  • What will I be given for pain management?
  • When will I begin physical therapy and for how long?
  • Will I need crutches or any other equipment after surgery?
  • When will I be able to return to work and normal activities?
  • What are the risks of delaying or opting out of surgery?
  • What will your long term follow up plan for monitoring the PVNS be? Check ups/MRIs
  • Are there any complementary or alternative therapies that I should consider? radiation internal/external, chemo, cryotherapy, homeopathic?
  • What are the risks and possible side effects of each treatment including long term effects?
  • Are there any clinical trials that would be appropriate for me?
  • Do you recommend any herbs or other supplements- such as fish oil or glucosamine?
  • What should I do if my symptom worsen?
  • What can I do to decrease the discomfort?
  • What can I do to preserve my joint?
  • What kind of out-of pocket expenses can I expect; are payment plans available?

Monday, December 12, 2011

Two Days Until Surgery


I'm so ready for all of this drama to be over. I like wearing shorts and skirts but now I'm going to have an ugly scar on my knee and I'm angry. I’m only 47 I've had over 20 surgeries and now scars on every part of my body. I'm angry that I'm going to have a huge one on my knee where everyone will be able to see it. I've learned to cover most of my scars by wearing the right kinds of clothes but in Arizona how are you supposed to hide a huge scar on the knee. I'm not vain, well maybe a little. I have a very handsome younger husband who loves me very much scars and all but sometimes I feel bad about being all scarred up. 
I know I could have the surgeon only use the arthroscope but I also know it won't provide the best chances of destroying this hideous monsters bone eating destruction long term. I don't want more surgery than is absolutely necessary, but how is one to know?  I suppose that's where trusting your surgeon comes into play. Cartoon from: klefever.blogspot.com
 I saw my primary care doc on Thursday to get my health clearance for surgery. He was very honest with me and said he really didn't know much about PVNS. I told him my take on it in the short amount of time we had. I was joking and said I was going to have a centipede tattooed on my scar. He just laughed. He's the kind of doc that everyone should have. He really cares and has very good intuition of what a patient is going through.
The good news is that I will have my back MRIs done tonight and it should rule in or out some stuff. Maybe I’ll actually find out why I went to the doctor in the first place