Billy Bob's Wild Ride: From the frying pan into the fire

Wednesday, August 16, 2017

From the frying pan into the fire

Notbillybob had just visited the radiology records dept. at Anschutz aka the "U", and was scurrying to make it to his hepatology appt on time, you know, reading while walking briskly, reading, skimming over the boring parts, yada yada, There was a hepatology appointment, followed immediately with an appointment with the pre-admissions clinic, but back to the radiology report...

He started reading the paper, wondering what the news would be...

66 minutes after IV tracer was administrated, bla bla, CT images were reconstructed in the axial, coronal and sagittal views...sure, yeah, width wise, lengthwise, and sideways... where is the news, where are the results of yesterdays scan? And then he saw the words on the paper, right at the bottom of the first page...h h holy crap! Can... not... breath, hearts... pounding...ringing in his ears...

Feeling faint, that metallic taste spreading in his mouth...

A NEW DESTRUCTIVE LESION IN THE RIGHT SCAPULA INCLUDING ANOTHER PATHOLIGIC FRACTURE THROUGH AND THROUGH THE BONE, ............

ANOTHER LESION, IN THE

THE GREATER SPHENOID WING

(THATS IN THE RIGHT SCULL BASE!!!), OBLITERATION OF THE RIGHT FORAMEN OVALE, FORAMEN SPINOSUM, AND THE PETROUS CAROTID CANAL.......CAROTID????

"> THE GREATER SPHENOID WING IS A BONE

RIGHT IN THE BOTTOM OF THE SCULL RIGHT BEHIND THE EYES....HOLY SHIT.....(BROKEN SHARDS OF BONE RIGHT ON TOP OF HIS BRAIN...TOUCHING IT...

.......WTF..... GONNA

FAINT

RIGHT THERE

IN THE ELEVATOR

BETWEEN THE 3RD AND 4TH FLOORS...

He and Princepessa had to sit down on a bench in the hall to catch thier breath and read it again, slooowly,

" please google this word, hun...

GREATER SPHENOID WING........

please...google... it... his mouth full of cottenballs suddenly...

There's been a lot of pain in the right shoulder, sure but he thought it was from using only the right hand and arm. But there was a crack sound last week trying to push up off the bed. Now he's been getting Principessa to help him get out of bed. But it explains the cracking noise. This marks the third bone he's broken doing something normal.

Princepessa is sobbing... she's been helping him get out of bed these days. doing ALL the driving, cooking, laundry,

but then

She's been doing everything since he broke his left arm, all though he did mow the lawn last week. But he didn't know it was broken. So, where do we go from here? I guess take one thing at a time, and don't look too far forward or it will drive him crazy. He was rather worried about Thursdays surgery, but now it seems minor compared to the fight ahead. Four lesions. Wondering if this will change his chemo tharapy drugs. Drugs which cost ...wait for it....

$13,000.59!!!!!

59 put in there for levity...but really, 13 grand?????????

Stay tuned and thanks for all the moral support kind words and your thoughts and prayers. It does help a lot. Billybob for Notbillybob 3:31 am Tuesday July16,

2017.

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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)