Tuesday, September 3, 2013

Information on an "As Needed Basis"

Living with cancer is an evolving experience.  Back in April, I realized that I wasn't experiencing pain that required me to be on Oxycontin and started the four-month process of weaning off of it. I knew, at that time, that eventually I would probably need to go back on it. I have conflicted feelings about the stuff.  I certainly hope that I'll never need it in the future, but in all likelihood, there will come a time that I will be thankful that it's available to me.  

Since I've gone off of Oxycontin, I have been fortunate enough to have very little pain.  There are some days when I don't have any twinges at all.  (I love those days!)  However, two weeks ago things changed, a bit.  I woke up with right rib pain in a specific area near my upper back.  I only felt it when I moved my arm a certain way, but it was sharp enough to take my breath away.  For five consecutive days I woke up to the same pain, so I finally called my oncologist.  He ordered a chest X-ray to make sure I didn't have any rib fractures.  The good news is that I don't.

The not-so-good news is that I now have some bones changes that are more associated with pain and fractures.  Rats.  Initially my bone mets were of the 'blastic' variety.  Blastic bones lesions are areas of over calcification and are less associated with fractures. The other type is called 'lytic' bone lesions, which significantly weaken the bone matrix, causing them to break easily. Of the two, blastic is the way to go. What I didn't understand, (someone probably told me this earlier but it didn't stick), is that blastic mets can change into lytic mets over time, and this is what's happening to me.

I met with my oncologist wanting to know if this now means that my oral chemotherapy is no longer working. He gave me the definitive answer of, "Not necessarily." Last month my most recent scans indicated that my disease is stable.  The fact that I am experiencing some bone pain doesn't necessarily mean that my disease is progressing, but it does mean that the progression of bone changes is continuing. I now take more calcium and vitamin D supplements, along with a monthly IV treatment, to help reduce my risk of bone fractures.  

I have learned that, early on, folks with bone mets often don't have pain. (I was pain-free for many months. Other folks, however, discover they have bone mets due to a fracture.)  The pain then comes and goes, eventually being more present than not.  Continuous pain is why medications like Oxycontin are available to cancer patients. This time I have been able to treat my rib pain with ibuprofen and right now I feel a lot better.  However, these past two weeks gave me a taste of what may lie ahead for me.  Needless to say, it makes me sad and a little scared. 

I have had to take in this type of information slowly, on an 'as needed' basis.  Now that I know, I'll be better able to prepare...meaning that I'll have my bottle of Oxycontin close by.  
P.S.  Still working, exercising (more gently), and other regular stuff.  


Shirley Kroot said...

Keeping up with your blogs. Good news, bad news. Glad you have some good news to offset the not-so-good news. Stay strong. Love Shirley

Wanwan said...

Thinking of you and your family often. Thank you for sharing, being strong, staying calm (as you can!) and carrying on. - Jeri