The Exhaustion Edge #55

Back in December I started feeling a low back pain that I couldn’t quite determine if it was bone pain or simply a pulled muscle. I thought I’d just wait until my PET/CT end of December to see if anything was going on. Well, something was amiss on my scan – a portion of my hip bone the cortex has been eaten through by the cancer but really didn’t warrant anything other than increase pain meds a little bit and refill Celebrex. The corex is the outer layer of bone. It’s waht makes the bone hard while keeping it sof and spongy on the inside. I still thought I had pulled a low back muscle as the pain had slightly subsided when my Celebrex (my daily anti-inflammatory med) had been refilled. The Nuker helped me understand that differentiating this type of bone pain vs. a pulled mucle would be hard as our ligaments, tendons and muscles all attach to our spines in this triangle shaped area. My lesion is just to the right of my right SI joint (sacroiliac joint).

In January, I started the Breast Cancer to Bikinis program working out 3 times a week. Unfortunately I exasperated the pain causing lesion in my low spine. So, I stopped working out and was steadily increasing my pain meds with very little pain control. I decided to move forward with radiation to help. In an MBC patient radiation is used to alleviate pain in bone mets, not for cure like last time I had radiation. However, bone can only be irradiated once. The next time has to be at least 2 years out. Therefore, I have requested we be as accurate as possible within the radiation fields. I have many lesions and while they don’t hurt now, they may in the future and I want to have to option of acting on them then.

I had started my new chemo combo (zoladex, faslodex and ibrance) and was working through the side effects and scheduled an appointment with The Nuker. We scheduled a Pelvic MRI and here is what it said:

  • Results are compared to the Dec. 21, 2015 PET/CT. Lesions appear worse despite different modalities. For example: lesion within left lateral Ischium appears larger measuring 2.7 X 1.7 cm (previously 1.0 cm), Lesion within the right Sacrum (tail bone) apperas larger measuring 2.9 X 1.6 cm (previously .7 cm). and lesion within the right Ischium apperas larger measuring 5.0 X 2.2 cm. (previously 3.0X1.2 cm). No acute fracture or dislocation is seen. Bilateral hip joints, SI joints and symphysis pubis appera intact. No intrapelvic mass or adenopathy is idebtified. And no abnormal fluid collection is seen. 

Based on the Pelvic MRI and the pain I am experiencing XRT (radiation) will really help. This is not like the External Beam Radiation I had 4 years ago. My skin will not blister and peel. Actually, I’m getting only 10 sessions. I will be tired, to quote The Nuker “pushed over the exhaustion edge” because I will also be on my 2nd cycle of chemo but it will help 90% of the pain within a week. It’s a very pin point directed radaition beam and will help rebuild the cortex that has been eroded from the cancer. Healing will get better when I’m officially done March 10th.

Below are pictures and videos of what my MRI and PET/CT of my pelvis look like. That’s The Nuker explaining everything, pointing out the right Ischium (where the big hole is). Healthy bone is the gray areas where cancerous bone lesions are the white areas on a PET/CT while on an MRI it’s flipped. Both videos explain a lot. In the MRI video the conversation mentions pelvis stability. In my left Ischium there is a mottled apperance with too many to count lesions. Even though I’m not experiencing any pain, radiating those areas will help with hip stability. Something I need to consider.  I have started XRT yesterday, once a day for 10 days. I also got my Zoladex and Faslodex shots yesterday and slept almost 15 hours last night. I’m not feeling to bad today! Looking forward to being pain free again and start excercising with my B2B ladies!

Radiation Room

Radiation Room