Subtlety is not one of my strengths
Dad's Status Page
March 16, 2008
Dad had a CT to identify where to aim the radiation (toward his spine/L1). He'll start receiving those treatments on Monday March, 17. We are hoping that the radiation will alleviate some of the pain he's feeling.
Thank you very much to everyone who has offered and provided help, advice, or an ear. We are preoccupied right now, and may sometimes forget to say thanks. But we are grateful.
March 12, 2008
1) The spot on Dad's spine is cancer that spread from his lung.
2) Recently, he's been in a lot of pain, whenever he moves. He had been on vicodin (?), which was ineffective. He's recently been given some combination of pill-based and oral syrup morphine. As of last night, it hadn't been working, either.
March 7, 2008
Dad had the spot on his spine biopsied, yesterday. Should know the results, by early next week.
February 25, 2008
For some reason the previous edition of this was returned. Please enter the substance of the report (that spot shows signs of malignancy and another biopsy is indicated.)
Begin forwarded message:
> Dear Mr. Small,
>
> Here is a copy of your CT scan report. I will refer you for a CT guided biopsy.
>
> Document Text CT OF THE LUMBAR SPINE
>
> ** HISTORY **:
>
> ** FINDINGS **:
> There is a lytic lesion in the right side of the L1 vertebral
> body. This is suspicious for metastatic disease. CT guided
> biopsy could be performed. This lytic process was not seen on the
> prior study of September 27, 2007. Recent PET study shows
> increased activity from January 8, 2008. The findings are
> suspicious for metastatic disease. There is also multilevel
> moderate discogenic degenerative disease throughout the lumbar
> spine. There is loss of disc height and osteophyte formation.
> Degenerative intraosseous cysts are seen at the L4-L5 level.
> There is no spondylolisthesis.
>
> ** IMPRESSION **:
> 2 x 1.5 cm lytic mass in the right L1 vertebral body suspicious
> for metastatic disease. CT-guided biopsy could be performed.
February 13, 2008
Dr Duong(my Chemo. Oncologist) called to inform that they will NOT, at this juncture, do the anticipated biopsy. Apparently the "spot" is too small. Instead they plan another CT to see if, perhaps, it has grown. If it has not, one of the options they will consider is an open biopsy.
February 11, 2008
I have an Appt. with Dr. Rotas (the premier oral surgeon in this
area) on Tuesday (2/19) for a consultation.
I have an Appt.
for a CT guided biopsy on 2/27 at Morse Ave.
February 10, 2008
Biopsy: Dad is going to proceed with the biopsy, as soon as he has a few more questions answered regarding risk.
Teeth: Dad's friend ( a dentist) had advised him against having the dental surgery, because he was immuno-suppressed. Dr. Duong disagrees with that, and indicates he's not immuno-suppressed. So Dad is once again having the dental surgery.
January 27, 2008
Three updates:
MRI: Dad's version (I think it's important to him that this gets relayed): “the MRI was inconclusive, but showed something on my spine. Duong is seeing whether a biopsy is possible or even beneficial.”
Dr. Duong's version: “So the radiologist who read your MRI did not see any clear evidence of metastases. He, however, did not say the spot that we see on the CT and PET scan is definitely not cancerous. I will put in a referal to interventional radiology to see if a biopsy is feasible or helpful.”
While these are similar, I don't think they're quite the same. I interpret my father as asserting that they think the cancer has spread, and are deciding whether or not to biopsy the spot before cancelling surgery. I read Dr. Duong as saying the MRI didn't show clear evidence or cancer, and that they need to see whether a biopsy is necessary before proceeding with surgery.
Teeth: Dad's version: He bit down on a piece of gristle, and severed the root on a tooth. After a lot of effort, he finally found someone who could look at it, and they concluded that he will have to have all of his upper teeth removed. Furthermore, the doctor who saw him indicated that he thought Dr. Moore would likely call off the surgery, due to the infection in my dad's tooth making surgery risky.
I have no version other than Dad's. I'm convinced much of it is transmission error (dr. to him, him to me, and his own biases towards conclusions regarding surgery). That said, it's important to realize that this additional complication is outstandingly stressful for him.
Mom: Not directly Dad's health, but definitely important in understanding how he is doing. Mom has been falling with increasing frequency. Early Friday morning, she fell and was taken to Kaiser emergency, with a grapefruit-sized bruise on her hip. (One of the blessings of her condition is that she doesn't remember that she did this.) They're keeping her in the hospital for additional tests until at least Monday morning. When she goes back to Carleton Plaza, she will likely need a “buddy” with her. (It's unclear during what hours of the day...Gwen, Zachary, and I heard that nighttime hours were most important for now, but that it would be increasing as her dementia progresses. Dad heard that she needs 24 hour fall-prevention. If Dad is right, the preferred fall prevention option will likely be constraining her to a wheelchair during the day, which will undoubtedly make her unhappy, but only when she's reminded that she is sitting in a wheelchair.
January 19, 2008
Dad's MRI is scheduled for Wednesday, January 23, and he will probably not know the results of the MRI until at least Friday the 25th.
If the MRI doesn't show anything on that vertebra, they'll consider the “spot” on the PET scan an error, and proceed with planning surgery.
If the MRI does pick something up, they'll proceed with a biopsy of it.
Dad's pre-surgery consultation, January 14, 2008
Dr. Jeff S. Moore, M.D.
PET Scan/CAT scan
2 findings
Original cancer was diminished and also decreased activity
Another spot showed up on his backbone 1st lumbar vertebral bone
High suspicion that there's cancer there
Dr. Duong wants to order a needle biopsy, cat-scan aided
Want to give the benefit of the doubt, and take the main tumor out
But can't if it's spread
So we need to do the biopsy
Radiologist would do the biopsy
UPDATE (Dad reports that Dr. Duong reports that the radiologist is doubtful that there's anything there, and wants to do an MRI instead of a biopsy)
If biopsy shows its cancer, then we'll need to treat it with radiation/chemo for some period of time
Dr. Duong would work it out
Still can give more radiation to the upper lung area.
If it's malignant, it's inoperable, but not untreatable
It's a worrisome spot
Last Updated Sunday, March 16 2008|858 Hits 