ACL Surgery - The Boy Scouts Are Right...

                   ...Be prepared.

     

     About a year ago, I came home and surprised a burglar. I posted my experience on Facebook and one of my fellow lung cancer ninja friends, Lisa Goldman, commented:  "Oy. I'm sorry Luna. I'm always kind of taken aback when regular crappy stuff happens to us. It feels like a stage 4 lung cancer diagnosis should render us immune to any other shit."  I know Lisa knows how it feels to juggle the ups and downs of life while dealing with serious cancer.  At that time, I couldn't have agreed with her more, but now...at least for today, I feel differently.

      Two years ago I had a downhill skiing accident and partially tore my right anterior cruciate ligament, (ACL).  I realized after the accident that I hadn't prepared myself for skiing that year.  In the past, for a few months before a ski trip, I was in the gym training - doing strengthening exercises specifically for downhill skiing.  For many reasons, I didn't do that before my accident and I paid the price.  In addition to getting really hurt, I ruined a ski trip get-away with my dear friend, Vicki.  I was so mad at myself.  

     Since then, I've been a dedicated rehab-er. Without exception, every morning I roll out of bed and do calisthenics and resistance training.  Two or three times a week I'm at a hot Pilates class and am regularly on my stationary bike or elliptical.  All this is to work toward being strong... mind,body, and spirit.  You know, that triad I've written about in the past.  (Excercising, especially in a hot room, greatly helps me manage chronic achiness I have from metastatic bone disease.)

     Last November, I fell to my knee and tore my ACL completely.  Despite being stronger from regular training, my knee was very unstable.  I saw my regular orthopedic surgeon and went for a second opinion.  Both surgeons recommended ACL reconstructive surgery.  After checking with my oncologists and getting medical clearance, I had surgery last week.

     Post-surgery nausea was pretty awful for about 36 hours, but as far as my leg goes...so far, so good.  I have minimal pain and 7 days post-surgery, I've hit all the milestones needed to be optimistic about my recovery.  Thanks to an ice cooling system, swelling has not been significant.  I'm able to bear weight nicely and am walking around the house, with a brace. I have a Camoped to bike (without any resistance) twice a day, which has helped me bend my knee to >90 degrees already. Physical therapy starts later today.

     I hope my recovery continues to move in the right direction.  I'm certain that it's starting out well because, unlike before my last ski trip, I prepared myself.  I was stronger heading into surgery than before that last fateful downhill run.  My goal is to never make that mistake again.  Life certainly has its ups and downs - some ups are really high and some lows seem unbearable.  And...although I'd love to be immune from "any other shit", I'll do my best to be prepared when I can be, and...bring it on.  
       

     This knee surgery has been a distraction for a follow-up brain MRI I will have next week.   Hopefully, it will help sort out the small, questionable lesion seen on my last MRI.  Bring that on, too.  I'm not quite prepared for all possibilities yet, but I'm working on that now.

      I can't end this blog without thanking Wynn, Nina, Brigid, Seth and Renee, and Ann for helping me get through this past week.  Thanks, too, to our nephew, Harold - 5th year orthopedic surgery resident - for the referral to my surgeon.  You were right, Harold.  Thanks to Rachel, RN - who is taking care of business for me at work. 

 
 

CT Scans #12, Brain MRI

     Since being diagnosed with cancer, (over 4 years ago), I've had follow-up CT scans and brain MRIs on a regular schedule.  Initially, the CT scans were every 3 months.  Overtime, as we (my oncologist and I) gained confidence in my targeted chemotherapy's ability to control my cancer, we extended the time interval between scans. At first I was able to talk my oncologist into spacing scans 4 months apart, and eventually to every 6 months.  Managing cancer means being exposed to agents I hadn't had in the past - chemicals, radiation, radioactive materials, and magnetic fields.  There's no way around it.  So, I really appreciate being exposed to 50% less radiation with CT scans every 6 months instead of every 3.  

     There are, however, negatives to less frequent scanning.  As confident as I want to be in the ability of my targeted chemotherapy to continue to keep my cancer suppressed, whenever I feel the least bit of pain, I worry that my medication has stopped working and my disease is foaming again. So, although the general plan is to have CT scans every 6 months, I've had to have mid-interval scans, here and there, in response to a bout of pain - usually in my upper right abdomen. 

      Last week I had CT scans of my chest, abdomen, and pelvis, (with and without contrast.)  The results indicate that my disease continues to be stable, despite my concerns of right-sided pain - that comes and goes.  My blood tumor markers also returned within normal limits. I was genuinely surprised and oh so relieved.  

      My brain MRI is another story, of sorts...

      Late last month I had a routine follow-up brain MRI.  (I find it funny that anyone can call any brain MRI "routine".)  I get brain MRIs every 6 months because my targeted chemotherapy, Xalkori, doesn't cross the blood-brain barrier, so even if it is working well to control my disease below my neck, my brain remains vulnerable. 

     Well, this time, the neuroradiologist reported that there is a small "non-specific rounded focus" in an area of my brain called the corpus callosum.  It wasn't there 6 months ago.  The neuroradiologist wasn't able to characterize exactly what it is at this point, but it may be a little tumor or an area of demyelination...or nothing.  The recommendation is to have another brain MRI in 6-8 weeks to see if the lesion is still there, and if so, is it bigger and can it be better characterized.  I'm scheduled for another MRI in February.  I, of course, have communicated with my oncologist and the ROS1 lung cancer specialist in Denver about this.  Everyone agrees that a follow-up brain MRI is the next step.  I've had to find my peace with the second part of their recommendation, which is:  "...and just wait to see what happens."  

    There's nothing for me to do while waiting, so I'm doing my usual, and having knee surgery next week.  (More on that in my next blog post.)  

      In the meantime, I feel like the guy in the middle.  He looks, to me, like he's trying to keep a stiff upper lip while waiting to see what his fate will be. 

  

Wish me luck!