"Patient at Risk for Pathologic Fracture"

There it is. The last sentence on the CT scan report. The sentence the doctor didn't mention. "A lesion in the right femoral neck places the patient at risk for pathologic fracture at this location."

Google explained to me that the femoral neck is the top of the thigh one, just before the ball (head) that fits into the pelvis at my hip. It is a pretty vulnerable spot, particularly in Ottawa during such a cold, icy winter.

I usually get up with my daughter and walk her to the school bus stop. The last few weeks I have become increasingly nervous about out our walk. The stop is only a few houses away. But there is so much ice on the road, and a bit on our front walk, to be honest. It is time to hand this job over to Geoff for a while. I hate to do that. He has taken on so much of the household tasks since I got sick. I like to let him sleep in a bit in the morning. But the risk is too great.

If I were to slip, the chance of the femoral neck snapping seems to be high. Surgery would be required to fix it, whether it is pinning the bone together or replacing it with a prosthesis (as in hip replacement surgery). I expect it would be more disabling than my previous pelvic fracture. Since reading the CT report, I've been feeling some pain deep in my hip. The Tamoxifen I'm on can cause bone pain. Or maybe it is in my head. Maybe I'm making a mountain out of a molehill.

On Thursday, I see an orthopedist, and then next week, my radiation oncologist. They will be able to tell me more. Maybe the risk isn't as great as I fear. Perhaps Dr. M could use radiation to strengthen my bone. Having been off chemo since November, my bone marrow should be able to withstand the radiation. We'll see what they say.

But in the meantime, I think I best stay off the road.

A Very New Treatment Approach

This past week, I got the results of my latest CT scan. The tumours were stable, which I guess is good considering I hadn't had a lot of chemo through the fall. I had expected to restart chemo on Friday, but as we talked, the doctor decided to present a different option.

Since my tumours were stable and I'd been on chemo (Taxol) for over a year, she felt it was time for a break. She proposed continuing Heceptin and Pamidronate but stopping Taxol and starting Tamoxifen. The break would allow my bone marrow heal from the ravages of chemo and bone mets. My whole body would get a break from the toxicity of chemo, though I had tolerated it better than I had ever expected.

I started taking the Tamoxifen tablet with supper. So far, so good. Possible side-effected include hot flashes. That wouldn't be terrible, considering I have been pretty chilly since treatment began. But so far, nothing.

There are two matters yet to be confirmed about my new treatment plan. First, I don't know how often I will be going for the Herceptin and Pamidronate infusions. We thought the doctor said once every six or eight weeks, but on Friday we got much more frequent treatment dates. My treatment nurse reminded me that usually Herceptin is given ever three or four weeks. I'll call my designated nurse Monday to confirm my treatment timing. Second, I've been invited to join the Odyssey trial. It is a double blind trial in which I would either get Pamidronate or a similar drug called Zometa. The trial would require additional tests as well as interviews. I usually jump at a chance to participate in a trial, but I'm not sure I want to commit to the extra time when I'm supposed to be on a "break".

The doctor said I should look at this change as something to celebrate. Doctors like stability. I like shrinkage. I guess I expected the tumours to continue shrinking -- I was feeling really positive about the CT scan. I guess a year on chemo is enough. Don't be fooled, my friends, there's still a lot of chemo in my future.

For now, I'll be counting on Tamoxifen and Herceptin to keep the tumours from growing.

Time for Testing, Again

Forgive me for not writing sooner. I've spent the last two months focused on family and celebrating Christmas.

I've had a break from chemo too. My last two appointments were cancelled in advance of my CT scan, which is tomorrow. It is an unpleasant test. I have to slowly drink 40 oz. of liquid that tastes like dirty pool water. At least, I am able to use a flavouring powered or syrup to mask the vileness. It helps, if you like lemon flavoured pool water.

I would appreciate your thoughts Wednesday morning as I undergo the CT scan. I will have the results next week, followed by chemo on the 18th.

I hope you enjoyed the holidays, as I did. I am very glad to be able to wish you all a happy new year!