When Surgery is Good News

Hey readers,

So we're going to be going with a relatively short post this day. I suppose it's a good thing, not having that much to report and update you on. Mostly it'll be focused on news with my ankle.

After getting an MRI and some x-rays, I finally managed to get in to see my new ankle specialist. I went through the whole routine of filling out paperwork and running out of room where it says "List all surgeries with approximate dates" and having various nurses and doctors saying "Wow, aren't you a bit young for all this?" and "I'm sorry you had to go through all that." It's funny to see trained medical professionals act with the same stunned uncertainty that I see when "normal" people find out about my medical past and can't figure out how to express their pity and/or sympathy properly. But I did like the doctor, he listened to my opinions (I can't work with doctors that assume I know nothing and won't factor in my suggestions or treat me like an ignorant child), showed me what he saw in the MRIs and x-rays, and freely admitted that this was an extreme case and, rather than go forward assuming he knew best, wanted to get the opinions of some other doctors to see what they thought. I always like that, because I've had more than my fair share of arrogant doctors who think they know best and then turn out to be totally wrong.

The bone spurs are visible just to
the left of the screws

There is some separation of the bones that
is usually associated with older people

Now let's get into the specifics about the ankle. The x-rays and MRIs showed that there are some bone spurs on the inside portion of my left ankle, no real news there. However, he also spotted a stress fracture on the medial malleolus (lower tip of the tibia), which is right above where most of the pain has been located. It might be possible that at least some of the pain comes from this stress fracture. These are all pretty sedate problems for me, things can will either heal on their own or require basic surgery (which I'll discuss shortly) to fix.

The black areas surrounded by white
are where the AVN is most noticeable
(A dove-shaped area above and a
bridge-shaped area directly below that)

However, the MRIs showed a much more serious potential problem in the future. Back in 2010 I had ankle allografts on both ankles (basically removing part of my ankle and replacing it with donor bone) that helped with the damaged portions of my bones caused by AVN (a degenerative bone disease I got as a result of my cancer treatment's treatment, my not so little souvenir I picked up when I had to survive the cure). These donor bones were healthy and over the last few years they've looked very good on x-ray, everyone's been impressed by them. But looking at the MRIs of the ankle, the specialist saw that the AVN was now starting to affect the fresh, healthy bone. The AVN is very pronounced in the lower "knob" of the tibia and also in part of the talus (the part that had been replaced five years ago). Although it probably isn't causing my pain now, since AVN usually only hurts when it reaches the surface of the bone, which it hasn't done yet in the aforementioned areas, it will require additional surgery at some point. It could be years or decades from now, or it could be months, it's hard to say. Basically it'll happen when the pain comes back because of the AVN or if the structure collapses like it did back in 2009, which is what prompted the surgery in the first place.


Fortunately, the AVN is not an immediate problem, but it is something to keep an eye on. The more immediately problem (bone spurs) are a lot easier to fix. My doctor would prefer to be on the cautious side and err toward a minimalistic approach to healing, which I can totally get behind. The plan is to do arthroscopic surgery, which uses a small camera and instruments to see and clean out the damaged areas of the ankle, and then see if that helps sideline the pain for a little bit. Compared to the huge joint replacement surgeries I'm so familiar with, this is far less intrusive and debilitating. After the surgery, the specialist wants to see me every 6-12 months to get images of my ankle so we can check on its progress and catch any further damage early on, before it has a chance to morph into something major. Until the surgery, I've been given orthotics and a brace to help take some of the weight off of my ankle and alleviate the pain as much as possible. And I'll be back to using my cane to take weight off of my ankle. (The doctor felt bad for me, since I would "stick" (terrible pun) out, but told me I could use it to whack people. I think that's the moment I realized how much I liked this guy. Beating people with canes always makes me think of the man who tried to assassinate Andrew Jackson and the 67-year-old president wailed on the guy with his cane). All in all, it feels like this is something that can be taken care of easily and I'll be able to move past it with relative ease. I don't have a date yet for the surgery, but I'm supposed to get a call from the doctor's surgery scheduler to get that sorted out.

Until then, I'm going to keep chugging along and staying productive.
Ciao

Coming soon:
Keep an eye out for the next blog post, which will throw some hard truths and harsh spotlights on an issue that underlies everything in my life, and in the lives of millions and millions of other cancer patients and survivors.

PS: I don't think this was nearly as short as I thought it would be. Sorry for accidentally lying to you.

Gathering Momentum

Hello faithful readers!

I am happy to say that it has been an incredibly busy few weeks, and not in a bad way (mostly)! I've made a lot of progress along many different fronts and am trying to keep that momentum going and going and going. I think I can, I think I can, I think I can, I KNOW I can! Shall we begin?

First and foremost, I am beyond ecstatic to announce the end of the second draft of my memoir! I managed to take out a rather large chunk of useless tangents (put in the rough draft mostly to take the edge off the agonizing task of remembering the things I spent years trying to forget) and am that much closer to being finished with this whole project. In the near future, I'll be able to submit the work to an editor that Nick and I have settled on and from that point on I think it'll be a bit more work and then we can safely put this whole memoir thing behind us. Quite frankly, as important as I think my book is (I can't afford modesty at this point), the allure of fiction is always the siren song trying to pull me off track. I'll admit, I have done some work on some side projects, but the goal is to publish the memoir before I ramp up my efforts for the next major project (which I've already decided on and I giddy as all get out to plow straight into). I do find the fiction to be a nice release, especially from the more challenging parts of the memoir, but it's a constant battle to keep myself from sliding so easily back into my preferred genre. On a side note: I wrote a short story that I really liked. It's nice, I haven't finished a short story in quite some time, so you can imagine how satisfying that is to work on something so fun and familiar.

To learn more about the memoirs Nick and I are working on, you can read the article in the Poway magazine 92064 called Memoirs Recount Challenges Faced by Two Poway High School Graduates

The other major mark of progress is my work at physical therapy. As mentioned in my last post, I've been strengthening the muscles in my legs to compensate for what could be further degeneration in the bones or some other issue that has yet to be fully diagnosed. I know that the ankle pain in my left ankle is caused by a bone spur (see right) that I'll probably have to do something about soon. But over the last few months the pain has been getting progressively worse. However, because of all the work at PT, I've been able to slow down a lot of the pain's progression and even prevent it from getting worse at all in some instances. I'm definitely a lot stronger than I have been in years, with the full compliment of joints replaced and feeling somewhat like I did before this journey of mine began more than eight years ago. It's amazing to me how long it's been. I can no longer remember what it's like to be a healthy person, what having hair is like, dealing with the issues that once seemed all-consuming in high school and now seem infinitely petty after the long Odyssey.

I've also been doing my best to prevent myself from pulling away again. Although I have not updated the blog in a while, I've been on other social media outlets for short bursts of time and have been trying to get out to see friends and get out of the house on occasion. I finally put up the Facebook page as my "official" author page (whatever it's called), which I will post a brand new short story (see above) if I manage to get 50 likes by the end of August. I will also be pulling my collection of short stories On The Fringes of Awareness by the end of the year as I switch from Amazon to another company that will allow me more control over my works.

In addition, and more importantly, I've started the Surviving the Cure page on Facebook as well. Its goal is something I've talked about semi-regularly on this blog, and indirectly focused on for the entirety of it, to spotlight post-cancer issues that cancer survivors must face after they are in remission and trying to rebuild their lives (the life lived after diagnosis and beyond is called survivorship). Anybody who has read at least a couple posts on here knows that surviving cancer is way more than just surviving cancer. It's trying to put your life back together after so many trials and tribulations and finding that the journey is only just beginning. It varies from person to person, and undoubtedly I'm an extreme case, but perhaps that's why I'm able to speak from experience about the multitude of challenges that survivors have to face after they escape cancer's grasp. If you go to the Facebook page for Surviving the Cure, there's a detailed mission statement and, similar to the author page, if 50 people like the page, I'll be putting an excerpt from my memoir up as a thank you for helping get the word out there about the difficulties involved with surviving and rebuilding a life left in tatters from the scorched Earth war against cancer.

What I'm trying to do is get the message out there, so if you would be so inclined to share not only the Facebook page, but also this blog, with your friends and the like, it would be a good first step toward helping spread awareness about how difficult life can be when you're cancer-free. (Damn that's catchy, if somewhat dark). It's a subject rarely discussed, even with oncologists treating you for your cancer, and as a result there is substantially less support in place for survivors. Many are forced to tread water and figure out how to cope and fix the side effects from the treatments, on top of the after-effects of the cancer itself, used to save their life. Whether those side effects be physical, mental, or emotional, there needs to be a better system of support in place to ease survivors' transition back into society and a semi-normal life. My hope is that the farther this message gets spread and the more people learn about just how painful and difficult picking up the pieces can be, in some instances its even harder than the cancer itself, we can be that ray of knowledge that pierces the dark clouds of ignorance about one of the hardest challenges any survivor will ever have to face. (I'll admit, I just added that last part to justify putting the picture in. I needed to compensate for the lack of cute little animals that I normally put in because that's what people like to see. Here, tell you what...

You're welcome)

Thank you in advance for sharing,
Andrew