Conquering the Tube!

I'm sure everyone is wondering what we found out at Stanford this week and how I did with my MRI's.

The first MRI on Tuesday afternoon went quite well, in spite of the fact that I was given my sedation just 30 minutes prior to the procedure instead of the recommended 1 hour. We hadn't eaten lunch until we arrived at Stanford which was just before 3:00, so it didn't help that my stomach was full of food. However, I did really well and the tech was really good about talking to me through the microphone and keeping me informed of each step and how long it would take. A friend from my support group said it really helped her to cover her eyes with something so she wouldn't be tempted to open them and then see how close around her everything was. I took her advice and covered my eyes with a handkerchief. I tried not think about the correlation to a firing squad! I did have one brief moment of panic when I realized I was entering the tube before 4:30, the time I had asked everyone to pray. But I took a deep breath and in my mind sang the words to the hymn "Abide with me....". Of course, I only remembered the first verse, but it was enough to keep me occupied for the next 45 minutes. For those who have never had an MRI, those things are NOISY! Ear plugs are required and provided and they are still noisy. I soon realized that I was singing louder in my mind as the machine got noisier! One thing that helped, too, was that I didn't feel the edges of the tube touching me which would not have been a good thing for me. The tech's assistant didn't quite know what to think when I was finished and he came to help me off the skinny little table and I lifted one side of my handkerchief and said "peek-a-boo!" I was just practicing for the next event of the day - a visit with our little granddaughters. We headed on down the road with everyone else vacating the city at 5:00 pm on our way to Jen and Jeff's where we spent the night. I was really sleepy all evening and slept really well all night and was still tired the next morning from the sedation I was given. Jeff is still laughing cause I fell asleep in the middle of a sentence when I was sitting on their comfy couch talking to him!

Just as we were leaving Jen's Wednesday morning, this dizzy gal with the numb feet took another fall. Fortunately, the steps were shallow, the fall was onto their wooden deck and I landed on my side not my bum. Having shoes on spared my ankles from serious sprain. There was some hyper-extension, pulling and bruising to the bottoms of my feet. Jen quickly got an ice pack and ace bandage and I was able to ice and elevate as we drove back to Stanford. Walking was difficult that day, but I managed with slow, rather stiff strides. I was able to ice and elevate again that evening when we visited our friends in Mountain View for dinner and then again in the motel that night and Thursday morning. Felt much better on Thursday, although still a bit sore.

After the fall, it was back to Stanford on Wednesday morning for appointments with various people in the transplant department which lasted from 11:30 to 3:00, again leaving us with a "lick and swallow" lunch just before my check in time of 3:30 for my next MRI. My sedation was given earlier this time and my procedure a little delayed so I was really relaxed. My tech was very nice but not quite as talkative. It did help both days that the initial images took about 30 minutes then they brought me out for an IV of contrast for the final 10-15 minutes of images.

Thursday morning at 8 am we met with the Interventional Radiologist and his nurse coordinator. There was another compression fracture found in the upper lumbar region and there was evidence of small patches of myeloma throughout my bone marrow. There are also degenerative discs which could be caused by aging or as a result of all the compression fractures. He didn't want to do anymore procedures right now so that I can continue in treatment without further interruption. There have been too many interruptions over the past 6 months which has not afforded the consistency that is needed. We talked about options for pain control and he highly recommended some specialized physical therapy. This is something I've been asking about for several months. His nurse coordinator will include this info in her follow-up letter to my local oncologist so it can be ordered. There is an excellent physical therapist in Anderson, so am hopeful he will have the expertise that is required for my situation.

In answer to my questions, the radiologist explained why he preferred vertebroplasty over kyphoplasty. After much research and many tests, they have found that vertebroplasty gives a better long term result for myeloma patients. Also, the two different processes create very different environments in the vertebrae. Even though the inside of the vertebrae have thinned out significantly to the point of collapse, there are still bony structures there providing some support. This is an important consideration when repair is made in a myeloma patient. Vertebroplasty fills in all the space around the bony structures giving them added support and filling all of the vertebral cavity. It is an easier procedure and doesn't require as much sedation. Kyphoplasty is a much more involved procedure requiring a larger incision and more sedation. A balloon is inserted into the vertebra to make a space where a "ball" of cement is then inserted (that's what it looked like on the MRI today). It doesn't completely fill the space leaving the outer edges still vulnerable to collapse and when the balloon is inserted it crushes all of those important bony structures.

Before we left we made my follow up appointment with the neurosurgeon. Between his schedule and mine, I won't be seeing him until March 5.

We are still processing all of the info from the meeting with the transplant department and have a notebook full of information we are to read through, so I will share more about that in a later post. In the meantime, you can continue to pray for us as we make this decision.

Thanks to your faithful prayers I conquered the tube!!