Billy Bob's Wild Ride: The spread of Hepatocracy

Thursday, September 11, 2008

The spread of Hepatocracy

If I were running for office, here's what I would say.
As an active member of my party , I am a firm believer in Hepatocracy. That is, the hepatistic values of the Livertarian party have been kept, and held sacred. Once our values are allowed to be corrupted, then all is lost. Hepaticism is a valuable , and ancient belief. In ancient Greece, Hippocrates believed in it. The ancient Chinese knew how important a role the liver played in the total human experience. Later, in Europe, Laennec carried on the traditions of hepatocracy. Here, in Bobby's abdomen, let me just say, that because of the perseverance, and endurance of the party's values, this struggle is being waged from all sides. You've heard the saying "We hold these truths to be self evident that all men were created equal." But do you believe that all men's livers were created equal? If you believe that, then you are indeed gullible. In here, the politics of gastroenterology is a deadly struggle, a life and death FIGHT to survive despite all that stands in our way. You think you've seen corruption? You think you've seen inequality? Let me tell you something about inequality, when a kidney has to fight to survive despite it's big- fat- owner not having the smarts or self control to push the plate away, or go for a walk, or join a gym. NO, in here we, the organs of your body have to do everything we can to survive despite being genically predisposed to certain diseases, and the constant onslaught of life itself. A tax hike wont cut it in here, nor will tax cuts. Blood and guts isn't an R movie rating in here, it's reality. It's the truth. But you cant handle the truth!! SO YOU GO AHEAD AND EAT YOUR CAPTAIN CRUNCH AND DRINK THAT PEPSI AND VODKA FOR BREAKFAST, AND SLAM THOSE BEERS WITH YOUR CHICHARORON BURRITOS AND YOU IGNORRRRR YOURRRRR CHOLESTOROL
READINGGGGGGSS FROMMMM YOURRR LASSSSST PHYSICALLLLL AND EEEEEEEEYYYYYYYAAAAAAAAAAAAAAAAAAAAAAAAA...

ahhemmm. uuhhunggggggg.

I'm Billybob and I approve of this message.

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Solitary plasmacytoma

Solitary plasmacytoma is a large solitary focus of plasma cell proliferation.

This tumor has a median patient age of approximately 10 years younger than multiple myeloma.

Pain is the most common symptom. However, if the myeloma occurs in the spine, it will usually present with fast developing paraplegia and gibbous deformity due to the vertebral collapse.

Complete Information on this Tumor

Introduction and Definition:

Solitary plasmacytoma is a large solitary focus of plasma cell proliferation. This tumor is extremely rare and is found in the proximal femur, vertebral bodies, and pelvis in order of descending frequency. Solitary plasmacytoma occurs 70% of the time as an osseous lesion, and the rest of the cases are non-osseous lesions usually found in the upper respiratory tract. Approximately 70% of the patients with solitary plasmacytoma develop multiple myeloma.

Incidence and Demographics:

This tumor has a median patient age of approximately 10 years younger than multiple myeloma, and affects men more than women.

Symptoms and Presentation:

Pain is the most common symptom. However, if the myeloma occurs in the spine, it will usually present with fast developing paraplegia and gibbous deformity due to the vertebral collapse.

X-Ray Appearance and Advanced Imaging Findings:

Radiologically, solitary plasmacytoma appears identical to multiple myeloma.

Differential Diagnosis:

Most authors agree on a strict diagnostic criteria for solitary plasmacytoma. There may be no other radiological identifiable lesions, and bone marrow at another site must have no abnormal plasma cells. There may be no serum abnormalities and no Bence-Jones proteins in the urine. Some authors believe that the diagnosis can only be made if no other lesion is found for a period greater than 1 year.

Preferred Biopsy Technique for this Tumor:

Bone marrow biopsy

Histopathology findings:

Microscopically, solitary plasmacytoma appears as well to poorly differentiated sheets of plasma cells. These cells produce the same osteoclast stimulating factors found in multiple myeloma.

Treatment Options for this Tumor:

Treatment of solitary plasmacytoma includes radiation or en-bloc surgical resection. If abnormal serum or urine findings are present then the patient must be treated as if they have multiple myeloma with chemotherapy and bone marrow transplant 2.

Outcomes of Treatment and Prognosis:

Patients with solitary plasmacytoma have a better prognosis than patients with multiple myeloma, but 70% of solitary plasmacytoma patients develop multiple myeloma, and usually die within 5 years.

Graduation Day

LINAC U

You'd think that 25 radiation treatments wouldn't amount to much of anything. It doesn't sound like a lot.

...25 trips to the hospital. We were wrong. We started the week before Thanksgiving after a month long delay because of a bad bad flu like cold I developed. They wanted a commitment, with as few absences as possible, so we waited. The coughing up blood and fevers subsided, then we started, and got our groove. I say WE because Notbillybob's wife, Sharon drove most days. I was just along for the ride. Well, after 10 treatments, the tiredness set in. Especially for her. Like a new part time job. Notbillybob feeling like a roast ham most days. Kind of like a sun burn inside your guts. He made a big mistake in eating jalapenos one night. Ooh, the burn. So, they asked the doc if the stomach was getting radiation. They said "lets pull up your treatment plan... Yes, see here, inside this red line. The treatment plan showed that it was. The innermost red line is the most radiation, the outer one is the least. The green one is in the middle. A good part of the stomach is even inside the blue line.

The pain was accounted for. They told us that they were also concerned with his platelet count. It was going down again. Down to 37! (Low is 150) It has since stabilized at 40. The thing is that the white cells, red cells, hematocrit are all low. Way low. Bilirubin is elevated. INR is elevated. Not billybob began wearing a mask to treatments. Don't need cooties at a time like this.

Then the really cold weather set in. I know, I know- it doesn't really cause colds and "death of pneumonia" like our moms used to say, but when you have cancer of the immune cells, and then your white cell count goes in the toilet as well...

Notbillybob is going to stay a hermit for the foreseeable future.

But SMILE!

New Years eve was treatment number 25. Graduation day! Graduation from LINAC U!

(LINAC is a Linear Accelerator, an IMRT radiation therapy machine)