2009 January 21st - Going Nuclear

I've been thinking about getting back to this blog for a while now, but deep down I think I associate it with being ill. Sitting on the sofa with a blanket, laptop on my knee with just the cat for company.

Back in November 2008 I started to get a sore pain around one of my left ribs, which wasn't helped by it being under my bra underwiring. It was annoying and there all the time and got worse after being away from the gym for four weeks (due to tummy bug and two other viruses) when I had 10 minutes on the cross trainer. By the time it got to 6 weeks, which is the time it should take for any muscular damage to heal, though I have no recollection of anything that could have caused injury and it started weeks before I got to sneezing with colds and flu, I made an appointment at the surgery. By this time I was in sharp pain every time I inhaled and deep breaths made my eyes water. Unfortunately the only option was to see the first GP who I saw about my illness which turned out to be stage 3 rectal cancer, it wasn't my first option, but she had at least requested some tests, though recorded my blood loss as spotting - it wasn't spotting!

As seems to be typical for me I had to wait over Christmas for the results to come back for any confirmation of a broken rib and leaking calcium in my blood (x-ray and blood tests). They came back normal.

The pain was getting better by this time, possibly aided by my expanding my rib cage a lot while I finished stripping paint and paper off the ceiling and walls and eventually got to painting. What hadn't improved was the growth around the rib - it's like the rib has doubled in thickness and is now more prominent than any others. I made an appointment at the oncology clinic, having tried in vain to make an appointment at the surgery - usual story, nothing to pre-book so you have to ring up at 8.30 every morning and try and snaffle an emergency appointment.

The Lone Ranger (my onco) was on holiday for the first week of January so I saw him on the 15th. He'd been storming his way through the clinic and I barely sat down when I was called through EARLY! The nurse on that day was the same nurse who used to work in endoscopy and was the first person to comfort me on finding out I had cancer in December 2006. I can still bring to mind a mental picture after the surgeon left us, in a darkened, otherwise abandoned ward - it being after 5.30. That's the moment my life changed and she was there so I feel a special bond.

I was in pretty good spirits considering, I'd managed to wait 6 weeks before checking it out, knowing that's what I'd have to do if I sought medical advice any earlier. I wasn't convinced it was cancer and knew how rare spread straight to the bones is. I just couldn't find any other explanation for a growing rib at my age with or without cancer history. I fully expected him to ask me some questions and then say there is really no chance of it being a tumour with my symptoms. Until the day before I thought about cancelling the appointmen, not wanting to be a time waster! That is until I was drying my hair after 20 minutes on the cross trainer when I got a really breathtaking sharp pain in exactly the same place. It didn't last too long but was a bit sore afterwards. He felt the rib and it is a bit tender still when pressed and I can still feel something, thought not really pain on certain movements. He checked that the pain was always in the same place - yes. Then he said we'll check it out with a bone scan. GULP.

Over Christmas while I was waiting for the test results to come back I spoke online with a breast cancer patient with multiple metastases in her bones, including her left rib in a similar spot to mine. She said that her tumours were not picked up on blood tests or x-rays - only on a bone scan. Even after they had been identified and she is having treatment for them they still don't show up on x-ray. At this point I was thinking I might have to demand a bone scan as the pain was still quite bad. As it wore off, I decided it must have been muscular but just taken longer to heal.......onco said there's no reason for me to take longer to recover now, this far out of surgery and chemo. Oh. OK. I'm not sleeping marvellously, unsurprisingly and I have been very tired for the last three months, which I told him I think must be down to viruses and just the fact that it's winter.

So I'll be back to Pilgrim on Friday at 11.30 for my nuclear injection and then a three hour wait (and hopefully something good from the hospital canteen for lunch) before my scan at 14.30. I'll see the Lone Ranger again the following Thursday at clinic.

Since then I've been researching spread to bones from colorectal cancers and have come up with the following from research papers:

Bone metastases are more common than previously thought.
The average age of patients with bone mets is lower than that in patients without.
Cancers of rectum and cecum are more often accompanied by bone mets than other parts of the colon.
Bone mets alone with colorectal cancers are very rare.

So that's not terribly helpful - it means it's bloody hard to find anyone to talk to who might be in the same position.

More frustrating is that I can find nothing about having an enlarged rib, where it's actually the bone that gets bigger that is not some sort of tumour malignant OR benign. If it was a soft tissue growth then I can find allsorts of stuff, like cysts or infections. The skin isn't red or inflamed.

I just don't FEEL like it's cancer, which I was sure I would if it showed up again. But then I think back over all the months of various aches and pains which I resolutely ignored and excused as recovery from chemotherapy and remaining side effects of radiation. I've had a lower back pain again over recent months which was where it all started, I put it down to the car crash back in 1992 but it turned out Tyson was just causing pressure, the pain went with radiation. It's not as bad now by any means, but is it an old injury exascerbated by radiation and chemo and age or more tumours? The aching and sharp pains in my hips, knees, ankles, elbows and wrists - are they down to the chemo still, the radiation, tennis elbow from painting? Ankle and wrist from the fall I had back in August? They should have healed by now but I don't want to spend my time at the GPs checking out the multitude of niggling things I have - I'd never be at work or at home or getting on with my new life.

The bone scan, which I assume will be a full body one will at least answer all of those questions for me. Then hopefully, I can get back on with things! Or start an entirely new chapter of my life. I keep pushing those thoughts away because there's just no point trying to plan around a recurrence until you have the facts. I've done a pretty good job of keeping hysteria away from my mind and I'm not about to let it take over now. Well, I do a little bit in bed, in the dark, alone. Who wouldn't?