Tuesday, January 10, 2012

The Dark Side of Morning

As has happened for the past few nights, I have been dragged slowly and inevitably from the depths of sleep at almost exactly 4 am. Whereas the back pain is usually the primary source of pain, these days it often takes a backseat to the bone pain that I feel in my left femur (the upper leg bone, and the biggest bone in your body).

I know I've talked about it, though it is worth mentioning again that I broke this femur in a motorcycle accident in 1991, and there is also a rod down the middle of the femur. It seems odd that a 20-year old injury (that has caused me no pain at all since about 1994) has started hurting again within the past 2 months, and so deeply and intensely. I have been told that old scars and wounds can reopen during chemo, but I have not yet been able to get an answer as to how this might relate to old broken bones. And also: chemo is over, already.

Of course, my brain goes straight to bone metastases -- or "bone involvement" as doctors so gently like to put it. I've had bone scans (but, admittedly, not since before I felt this pain) that *should* catch any metastatic disease in the bones. Though I'm still unclear exactly how bone scans work: I don't know if they're head-to-toe scans, or simply confined to the same area they're doing the PET/CT on, as some sort of bonus ("buy a PET/CT now and get a free bone scan!") freebie. After my last PET/CT scans in October, Dr Grampa (my now-former oncologist) told me that my bone scan was negative. I was surprised: I hadn't been told that I was even getting a bone scan, I thought I was just getting a PET/CT. Yet they somehow managed to do it at the same time using (apparently) the same equipment, without me knowing. Maybe its just a guy in the control booth eating a sandwich who looks over at me lying on the table -- really carefully -- for like a minute, and then checks a big box that says: "Bone Scan = Awesome."

All I really know about bone scans is that in the movie "The Pursuit of Happyness" (sic), Will Smith's mustachioed character sells bone-density scanners when he's not napping with his young son on public bathroom floors, getting arrested, working his ass off for the unappreciative Man, or having his wife leave him. You should watch it: its really an uplifting movie. In the end, it taught me very little about bone scans, though.

But the main point being: my leg hurts. And so far no one knows why. Add that to the list of complaints that I need to talk to an orthopedist about, which will happen at Mayo in a week or so. 

Yesterday night when the leg was hurting I thought it might be because I'd walked more than normal that evening (about 2.5 miles), more than my usual route. And when I woke up last night I took an oxy(co)done because the pain was keeping me from sleeping, and also because the docs are always bugging me to take them for what they call "breakout" pain. So I did, but really felt no relief from it at all until about 6. And then I slept uncomfortably and groggily until about 9:30.

The Oxy-co-done is a shitty sleep aid, I find. It leaves you not rested and fresh as a daisy, ready to solve the world's problems... but instead the Ox claws you slowly awake until you find yourself in a (hopefully metaphorical) greasy heap: sleep having snuck out on you without paying the rent some time ago when you weren't looking, and leaving you glaring grumpily at the sun and feeling like you ought to be deciding between warm beer or vodka from a styrofoam cup with a cigarette floating in it for breakfast. As it turns out, I had yogurt, granola and a banana -- but it felt like I wasn't really being true to the character.

Tonight I did not go for a walk at all, partially to see if there was any difference in the pain. There wasn't. So I might as well at least get the exercise of walking if I'm going to have the pain anyhow. I'm also not taking any of the extra Oxy tonight, for the aforementioned reasons. 

I look forward to getting this bone stuff looked at, and I have decided that if they also (as pretty much all of the other doctors have done) throw up their hands and say: "Huh. Well, that shouldn't be happening! I sure wish we knew what was going on, there!" I may start trashing the place. Luckily, Mayo is great at figuring out stuff that is hard to figure out, but I wasn't pleased with their Harlem-Globetrotters-esque lightning fast handoffs that I went through last time there, only to learn that my back/bone issues are not something that falls under the purview of urology, medical oncology, radiation oncology or neurology. Knowing what it is not is strangely not as satisfying as doctors might guess. I'd rather focus on what it is

Anyhow, the leg pain has subsided again for the moment, so I guess I'll see if I can get some sleep.


cmmastro said...

I have similar feelings about Ambian as a sleep aid. Yes, I am unaware and possibly asleep. The next morning feels a lot like a hangover though.

M said...

I agree about Ambien! It seems to work by making you forget that you weren't sleeping, so you assume that you were. Scary!

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