Wednesday, November 19, 2014

One down, twenty four to go

Hello, Facebook group for Billybobs wildride! This is Billybob, the worlds wackiest liver reporting the latest on the bone tumor aka Lester Diamond.
Yesterday was Notbillybob's  first radiation treatment at the CU cancer center. 

25 in total have been planned, one down,twenty four to go.Once a day, every day through Christmas.

                                         Marked and ready

         This years'  Christmas present from Sharon, a 1965 vintage Soviet NBC warfare watch
                         Molinja 3602, made in USSR

If you were on vacation back on July 23rd this year, or in a coma, Bobby aka "Notbillybob" had a chicken leg sized tumor
removed from his ribcage. It started out as a broken rib on December 8th, 2007.  He simply rolled over in bed on his left side, and SNAP!  They eventually named it Lester. It turned out that Lester was a Plasmacytoma, which is a rather bizarre tumor made from malignant plasma cells. It is  incurable, but can be treated and a good outcome is common these days. Not so just a few years back. Even a recently as 10 years ago, this was a pretty nasty disease as diseases go, at least according to several of his doctors. Modern medicine has found ways to fight this cancer, and the latest clinical trials are yielding pretty good results. In the case of Lester Diamond, though, things are a bit complicated. There are some strange signs that suggest that the cancer might be far more wide spread than previously thought. 6 months from now, we will know a hell of a lot more. First, an MRI of an additional tumor in the pelvis, then possibly a biopsy. Then several soft tissue tumors have to come out and go to the pathologist.
This cancer  "hides like no other" according to the head bone marrow oncologist at the "U". Then there is a possibility that Notbillybob is a "non secretor" or worse, a "non producer". That would mean in the case of a non secreter that the abnormal cells only live for 6 hours or less , making it very very hard to detect in blood or urine samples. A non producer simply makes no abnormal cells that science can currently detect, but only show up as an after thought as actual symptoms, such as elevated calcium, leading to kidney failure, lytic lesions (destructive lesions) in the skeleton, which hurt really bad and can cause central spinal collapse. Ouch.
You know how the construction crews are always tearing big giant
holes in the street? Well, imagine what would happen if they never came back to patch them up? In the case of plasma cell cancer, the process of removing old bone and filling the holes up with new growth cells  gets disrupted. The holes are made, but never filled back in. It's called "uncoupling".
A type of bone resorption cells called "osteoclasts" reabsorbs bone , and their counterparts called "osteoblasts" are supposed to create new bone. But in the case of plasmacytomas the osteoblasts go on strike.
That's what happened to Notbillybob's rib... over TWELVE YEARS AGO.

This is a 3d CT scan of his ribcage taken on 6-8-2007.

 To date, no radiologist has seen this 3D view. The regular view, called the "axial" view shows some tiny itty bitty pin holes. The radiologst who read it initially totally dropped the ball. No, he fumbled was returned for a touchdown.
Then of course as always, Notbillybob has a complicated case anyway. Nothing is ever simple. Initial test results are either mild, or negative. Then the other shoe drops.


This one still has the doctors scratching their heads.They use words like 'very rare', or 'bizarre', and in some cases they just drop their pens when told that the first symptoms were on an Elk hunting trip in Oak Creek Colorado, September, 2002.  Then the first hospitalization was Februrary 13, 2003 for chest pain while at work... his first ambulance ride. I mean, it's a long long time ago! It also explains a lot of bizarre health related things.
All the kings horses and all the kings men include:
A neuro oncologist, orthopedic oncologist, 2 radiation oncologists, and a bone marrow transplant oncologist , two thoracic surgeons. a nutritionist, and a chaplain.

So, we will update as it goes for those interested. Happy holidays and Merry Christmas!!!! And may your osteoclasts and osteoblasts be ever united!!!!