This will be long, but detailed (for any of the prostate cancer patients who keep up with this). We started the day today by seeing a neurologist (Dr. Ney).
He's right here at the University hospital and we were referred to him by our oncologist. You would think that someone might have warned us that the neurologist (Dr. Ney) has Tourette's Syndrome. So there was an initial moment or two while we were trying to figure him out.
But when we got over that hurdle, he was pretty awesome. With regard to Marshall's knee pain that comes and goes, Dr. Ney wants to see all of our previous hospital records and he wants to have two nerve tests done (a nerve conduction study and an EMG), but based on our lengthy interview with him and the silly tests he performed (not really silly, they just looked silly), he said he thinks it is possible that Marshall's knee pain could be something called radiation neuritis (which would be a long-term side effect of the radiation that Marshall had last Christmas). The nerve tests may tell him something about how the nerves are working. These tests should be interesting because they both involve electrical shocks. He said it lasts 45 minutes and would feel like being slapped repeatedly with a rubber band.
Also, he is fairly certain that Marshall has not had any mini-strokes. He wants to see any tests done on Marshall's brain, but he feels that it is highly likely that these episodes are stress-related and I must say that sounds perfectly right to me. He said there was a possibility of seizure but it was a slim possibility because Marshall's symptoms are "very atypical." We will be following up with him.
Then Marshall had lab work done. We went to lunch after that and then came back to the hospital to see the oncologist at 3:30. For the past few months we have been seeing the nurse practitioner, so it was nice to see the oncologist again. There is a comfort level in seeing the actual doctor periodically. And I am happy to report that it was all very good news.
The lab work was all normal.
BONE SCAN: He pulled up the bone scan and went over it with Marshall, comparing it to the previous bone scan. It showed that there is absolutely no evidence of new metastatic disease and all of the known lesions are "less conspicuous."
CT SCAN: The CT scan showed slightly more "uptake," but Dr. Flaig says this is not reliable and with regard to bone metastasis, the bone scan trumps the CT scan. But the CT scan also showed absolutely no new lesions and no organ involvement (liver, spleen, lymph nodes).
MRI: The MRI showed extensive bone metastasis, but it was in the areas we already know about. There was dense sclerosis, which he says indicates bone healing (meaning that the cancer shrunk and calcium started filling in the areas where the cancer was) and indicates healing. There are no compression fractures and no spinal cord compression.
Marshall's blood pressure was very high every time it was taken today but his stress level was also high.
Dr. Flaig said that since Marshall's bones are in good shape, we will hold off on the Xgeva (bone strengthener) for another month or two just in case the Xgeva was the cause of any of the pain he's been having. But they went ahead and gave him a flu shot and a Zoladex (hormone) injection today.
So we left there in high spirits, got a bottle of wine at the hotel bar and ordered some thai food and ice cream.
Now we will concentrate on the neurologist to see if he can find a cause for the sharp stabbing pains Marshall gets in his left knee and groin area. But the fear that these pains were cancer related is now gone and the stress level has toned down a lot.
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