Tag Archives: spine

Successful Surgery

November 21, 2017Carcinoid Cancer, Healthanesthesiology, neuroendocrine, octreotide, spine, surgerycy

Spinal surgery yesterday, going home today.

If you follow this blog, you know that I have been struggling to get a surgeon who would help me with my spinal and sciatic pain. Although the surgery is simple (as spine surgery goes), my neuroendocrine cancer makes me a “special case” because there’s a tumor in L3 and the surgery is for L5 – L4. A surgeon who refused to see me told me to see Dr. Anant Kumar. He takes us “special cases”. He agreed to take me and it seems to be working well.

Here is the problem we are trying to solve. It is called spinal stenosis. It means that the channel that the spinal cord runs in is narrowing and thus squeezing the spinal cord. In my case the canal Vertebral Foramen through the L5 – L4 was narrow for 4 reasons:

Because of disk deterioration the L4 vertebra had moved one way and the L5 had moved another, thus narrowing the channel where they meet by quite a bit to 5.5 mm when it is supposed to be greater than 13 mm. The procedure did nothing to attack that directly If more surgery is needed later, it would be fixed by the complex of wires and screws. We have done a simpler thing on Monday.
Due to aging, the material in the channel has expanded. This is cells growing larger and is called hypertropy. The procedure was to scrape out much of the material in the L4-L5 vertebral foramen.
There was a 14mm cyst on the L4-l5 facet joint caused by friction which happend because of the deteriorating disk. That was removed because it caused pain.
There was some bone spur caused by arthritis on these bones which was removed also because is caused pain.

The anesthesiologist, Dr. Santangelo took extreme care knowing that I had neuroendocrine cancer and that I had had a carcinoid crisis once before. I am told that two times the blood pressure did drift down where it shouldn’t be and he had to put more octreotide in the drip and the BP came back. Remember “special case”? It was good that the surgery took place at Presbytarian/St Luke’s Hospital where my neuroendocrine specialist, Dr. Liu works. Dr. Liu has done much to train the personnel about neuroendocrine and carcinoid crisis.

Both of the doctors working with me were great. I feel very fortunate. The sciatica pain, the numbness, tingling and weakness in my feet is gone!

Dr. Kumar tells me the arthritis pain in the back will remain. That’s OK, assuming that I can walk and fish again.

Thursday I can go to my sister Sarah’s for a huge Thanksgiving dinner. Hurrah!

Namaste,

How did this happen?

May 7, 2017Carcinoid Cancer, Health, Travelbirthday, carcinoid, spine, travelcy

Today, I turned 70 years old! How on earth did that happen? Below is a picture of my wife Laurie whom I blame for my continued existence more than anyone else. But I also depend on my kids, grandkids and all the rest of my large family (11 siblings) and my friends for their love and support. Of course the medical establishment has done much to keep me going, although I had to learn to battle them when I felt they were wrong.

I just spent 11 days in the Netherlands with Laurie, Derek, Kat and Ansel. It was a great trip during which we could celebrate Ansel’s 4th birthday, Derek’s birthday and my own birthday. We saw the Van Gogh museum in Amsterdam and saw some of the King Day (big holiday) celebrations in Amsterdam. We spent several days in Haarlem as well and had a wonderful tour of the tulip gardens with the tulips at their peak.

Kat had arranged for Airbnb accomodations in both cities and they were very nice. The very nice flat in Amsterdam was beautiful but was a 4 flight walkup. The old house in Haarlem had some stairs that were difficult but we managed.

The trip was marred only slightly by some problems with my sciatica. Fortunately, my

spine doctor had supplied me with a prescription for methyl prednisolone. I filled that and took it with me to the Netherlands which enabled me to get around most of the time. The injection’s good effects are not lasting as long as I would have hoped.

Yesterday was the 6th anniversary of my diagnosis but I had no problems with the Neuroendocrine Cancer on this trip.

Laurie, Margot, Charlie - Easter 2017 — Laurie, Margot, Charlie – Easter 2017

Eating Ethiopian Food with Ansel in Amsterdam 2017

Cy and Margot - Easter 2017 — Cy and Margot – Easter 2017

As usual with my list of diseases, the day after I got back, Friday, I went to the oncologist’s for my monthly butt dart (Sandostatin injection). Tuesday I meet with my oncologist to discuss the neuroendocrine cancer and perhaps the Netspot (GA-68) scan. Next Monday I restart weekly physical therapy for my spine. The beat goes on.

May we all have the best possible outcomes,
Cy

Clean Cystoscopy!

March 25, 2017Healthbladder cancer, cystoscopy, spinecy

It is a great pleasure to post positive health results in my blog. Not all is doom and gloom. This time I had a good, clean cystoscopy.

Cystoscopy is endoscopy of the urinary bladder via the urethra. It is carried out with a cystoscope. – Wikipedia

What that means is they insert a camera into your bladder via the urethra.

I had my first bladder cancer check since cancer was removed last September. The check mostly revolves around the cystoscopy. This showed no cancer!

This is the first time in about 3 and a half years that I have not had the cancer when the doctor looked for it. I have had to have it removed from my bladder four times and although that procedure is a day surgery, it is really not pleasant.

Bladder cancers are often treated with immunotherapy. In this treatment, a medicine triggers your immune system to attack and kill the cancer cells. Immunotherapy for bladder cancer is often performed using the Bacille Calmette-Guerin vaccine (commonly known as BCG). – MedlinePlus

This does not mean that it will not recur but, at least for now, I will not have to undergo another BCG treatment. I had that last summer and it was not pleasant. My doctor and I had discussed doing the BCG and adding interferon to it. I would have been even more sick for six to eight weeks during that treatment.

Other Health News

The spinal injection of steroids in early January has worn off. I will get another in early April, just in time to try fly fishing with friends and a trip to the Netherlands. Before the injection, I had feared that I would have to give up both fly fishing and travel. I could not walk more than a few blocks even with heavy pain medication. Now, physical therapy has brought me to a better place although by no means able to walk very far or stand for very long. The injection made me feel almost normal for a couple of months.

Overall, great health news this week. I will be seeing my NETs (neuroendocrine cancer) specialist within eight weeks. Let’s hope that also remains good.

May we all have the best possible outcomes,

Working on Back Pain

January 17, 2017Healthback pain, health, physiatrist, physical therapy, spinecy

Today is the first day since last April that I have not taken any form of pain killer after waking.

The medications have ranged from OTC acetaminophen, naproxin, ibuprofin to prescription Tramadol and Vicodan. — I have mentioned before that I have experience severe back pain since April last year. (My how time flies!) It got really bad during our last trip to Scotland in May. Of course. a lot of walking is involved while touring and I spent too much time sitting and waiting while my family toured and walked.

The pain was two types: the shooting lightning strikes down the backs of both legs – buttocks, hamstrings, calves; and a slightly less severe pain that just settles in the same places and also the lower back. For months I have not been able to stand long enough to make a piece of toast in the kitchen. Before last May, I was accustomed to walking three to four miles every day. Since then, when I use a hiking stick or sometimes two sticks, I could walk around the block. On my best days I could walk a mile.

Since then, I have tried many alternatives. My PCP provided a list of stretches for the back, some of which relieved some of the pain for a short while when I rose in the morning. He also tried a course of Prednisone tablets. This relieved the shooting sciatic pains for a month or so but the rest of the pain just seemed to settle in and take control. We tried a muscle relaxant with no good result.

I visited a chiropractor for two months twice a week with little or no relief. He finally told me that he could not find a way to help me.

Finally, both the chiropractor and my PCP referred me to a physiatrist. This is a traditional doctor MD who specializes in physical medicine and rehabilitation. They are often spine specialists and avoid recommending surgery except as a last resort. I must admit that I had never heard of this specialty. We learn a lot in our health journeys, perhaps especially as we age.

The doctor I chose three months ago has proven to be very helpful. First he order a spine specific CT scan. Bearing in mind that I have already been told that I have arthritis in all of my joints and that I have DISH (Diffuse Idiopathic Skeletal Hyperostosis) which is a disease common to 90 year olds and which gradually turns your ligaments to calcium, the CT scan report says:

Mild scoliosis (this is from birth but not causing a problem).
Mild arthritis
Bulging disks
Retrolisthesis – movement of the vertebrae from their proper place in the lumber region which causes:
Stenosis – abnormal narrowing of the tube through which the spinal cord passes.

In my case, the stenosis is considered severe. Apparently, the normal opening for the spine is greater than 15mm but mine on the last vertebra is 5mm. This is what is causing all the discomfort.

The physiatrist immediately started me on physical therapy and gave me a few days of a drug called methylprednisolone.

The physical therapy has been going for about eight weeks, once a week. We have made definite progress and mostly removed the pain from my calves, partly removed the pain from my hamstring and removed most of the pain from my right leg. The left leg and rarely the right leg still gets shooting pain in the hamstrings and occasionally severe pain in the calf. My buttocks still get quite a bit of pain. I still could not stand for more than about three minutes.

The methylprednisolone removed the pain almost completely for a few days but it gradually returned full force. The drug also made my stomach very sick for a week. The doctor told me that the results with drug indicated that I could be a candidate for spinal injections.

Yesterday, I received corticosteroid injections in my spine. Today I have only the smallest pain with not much problem standing or walking. WOW!!! Unfortunately, there is no way to predict how long the therapy will work. The doctor already told me to schedule more injections before I go to Europe in late April. I will continue the physical therapy because I am learning to sit, stand and stretch in ways to keep it from getting worse again.

This is not the end of the journey but I certainly appreciate a pause, however long, in the discomforts.