Tuesday, September 1, 2009

The (Brief) Return of the Neurosurgeon

The neurosurgeon points at the part of the bone scan image showing the ribs. It shows bright spots in exactly the areas that are giving me problems, strongly contrasting with the very much duller appearance of the bones and connective tissues elsewhere. This is what "increased uptake" of the radioactive tracer looks like, and it indicates that there is something other than just bone there. The neurosurgeon announces that he believes that this is the cancer itself at work.

This is the first time (aside from the cardiologist's failed hypothesis of effects on the heart) I have heard it suggested that the cancer is active anywhere other than the spine. If true, it also lets the neurosurgeon off the hook, because it means that,
in the longer term, the problem is being solved by the chemotherapy, which attacks the cancer whereever it exists.

In the shorter term, the neurosurgeon offers a boost in the strength of the Oxycontin prescription (but I already know that the oncologist does not want to do this); switching from Oxycontin to Lyrica (which the oncologist has already also offered, but I have so far resisted doing this, because Lyrica is notoriously difficult to get used to); or a back brace. I will take the back brace under advisement.

The neurosurgeon will forward all the images, along with his commentary, to the oncologist. It will be interesting to see whether the oncologist concurs with the neurosurgeon's interpretation, or generates one of his own. I have an appointment with the oncologist at the end of next week, to discuss the results of the second chemotherapy cycle.

As an aside, while discussing the appearance of the T8 vertebra in the X-rays, the neurosurgeon corrected a misunderstanding on my part concerning the results of the balloon kyphoplasty procedure he performed on T8. This procedure did not fully restore T8 to its original dimensions, as I thought; in fact it got T8 perhaps 20-30% of the way there, at most. The purpose of the procedure was not restoration, but stabilization. The images show that it succeeded in achieving that goal, at least.

No comments:

Post a Comment