Satomi's Cancer Blog

Yesterday we just got a call from Dr. Mortimer, the Oncologist we had initially seen at the City of Hope.  Apparently, the EKG that was taken during our most recent visit showed some minor irregularity in Satomi’s rhythm.  The staff Cadiologist must examine Satomi before her Wednesday procedure to verify that all is well before anasthesia is given.

I was disappointed and a bit upset as this would mean another long drive and more back pain for Satomi.  I nicely expressed myself.  The doctor was very apologetic but stressed its importance.  She assumed the irregular EKG was due to the confined cardiac space and irregular position of Satomi’s spine but in any case, they had to make sure things were OK.

Satomi took it in stride but shared my disappointment.  The Cardiology department was suppose to call to setup our appointment but has yet to do so.  I am quite anxious about it as we only have time on Tuesday, the day before the spinal procedure.  I would be quite upset if we have to delay it because of a scheduling foul-up.

With a positive attitude and a bit of pre-medication for the long drive, Satomi and I returned to the City of Hope.  It’s too bad I couldn’t take advantage of the pre-medication option-that drive is a pain in the booty.

The visit went quite well. 

We already knew where to park to minimize Sat’s walking-remember that walking is more comfortable than sitting so we try not to use wheelchairs.  Our wait was also minimal since I had verified on my previous visit that everyone was on the same page.

We started with a simple chest X-ray from the front and the side.  According to the Tech, it was primarily for the Anesthesiologist to verify that Sat’s chest was clear.

Then it got interesting.

We met Dr. Chen and entered their Fluoroscope room.  Here’s a stock photo of a Fluoroscope.

A fluoroscope is basically a complicated X-ray.  Instead of a still picture it takes real-time moving pictures.  Take a look here for more info:  http://en.wikipedia.org/wiki/Fluoroscopy

As you can see from the photo, the table tilts completely vertical.  It made loading and removing Satomi from the machine much easier.  All she had to do was step onto the ledge and hold on.

The goal of this scan was to verify which vertebrae were going to receive the cement.  Before our visit, the doctor had preliminarily planned to remedy T8, T10, and T12.  Even to the untrained eye, the damage to these vertebrae can be seen in the MRI.

During Satomi’s exam under the fluoroscope, it was determined that T12, L1, and L2 were more painful and should be the focus of the initial operation.  Other damaged vertebrae could be fixed in a separate and future procedure.

Surprisingly, the procedure is commonly done on an outpatient basis.  Given Satomi’s other ailments, the doctors are planning to perform the procedure under a general anesthetic which will likely require an overnight stay.

We discussed the specific type of Vertebroplasty that was to be used.  The doctor recommended the standard procedure (without any balloons or RF devices) but utilizing the most viscous cement available.  Apparently, Satomi’s vertebrae are fractured around their perimeter and leakage could occur if a thinner cement is used.

Dr. Chen also arranged an EKG and additional blood work in anticipation of the procedure.

The Vertebroplasty procedure was first performed in the mid-80’s but hadn’t become more commonplace until the late-90’s.  It’s popularity continues to grow.  Some nationwide estimates indicate a growth from about 3,200 per year to over 6,500 procedures a year over these past 6 years.

According to Dr. Chen and several online sources state that the risks of additional pain, spine/nerve compression, and cement leakage are typically 3% to 5%.  In Satomi’s case, her fractures are serious so the risks are elevated; the doctor estimated it at 10%.  If any of these problems were to occur, a small percentage of effected patients could suffer serious complications (pulmonary embolism, paralysis, etc.).  Overall, the typical risk of serious complication is less than 1% or about 2% in Satomi’s case (I’m taking the liberty of doing some math).

All-in-all, that sounds pretty good to us.  Maybe I shouldn’t be so optimistic given our recent streak of crappy luck.  But hey, it’s a new year and things just have to get better sometime, right?  I sure hope so.

The procedure is scheduled for next Wednesday January 6th at 9:00 am.  Cross your fingers!!

Satomi got her Zometa treatment today.  It went quite well and only lasted 30 minutes.  We sat together in the Chemo infusion room at our Oncologist’s office.  It’s been a year since we had been in that room.  It was a strange reminder of how far we’ve come.  Surprisingly, Satomi only needs a dose once every 6-months so hopefully it’ll be a while until we return there.

As I first mentioned in our “2nd Opinion” posts from early December, Zometa was recommended by (3) seperate Oncologists as a treatment for Satomi’s deteriorating bones.  Here is a link to more information:  http://www.us.zometa.com/patient/breast-cancer-bone-metastasis.jsp?site=PC000157&irmasrc=ZOMWB0081&source=01030

It is becoming increasingly difficult for all the Nurses and Phlebotomists to get a line into or draw blood from Satomi’s left arm.  You all may recall that the lymph nodes in her right arm pit were removed making her right arm off limits.  Her left arm is so bruised and tattered-It makes me sad to watch their feeble efforts and inevitable numerous needle stabs. 

Our Urologist got the kidney stone analysis back and they aren’t caused by Satomi’s chemo.  The stones are caused by the waste products generated by a bacteria living in her kidneys.  The remedy is a low-dose of antibiotics for the next few months.  At the end of this period, there is a possibility that the stones will dissolve on their own.

In the mean time, the old criteria still applies.  If she suffers from intense nausea or an unexplained temperature of >101.5°F, we are to go to the ER.  Otherwise, we can focus on the balance of Satomi’s treatments and just move on.