Stimulated Bowel Movement
Well, I told you this blog was intended to be more “medical” and about getting through these things, so sorry if this is TMI (too much information). :)
Yesterday I just felt like I had to do something. Let me make sure my current situation is addressed:
I was diagnosed with Multiple Myeloma-IGG 10/05. I was 60% cancer cells in my marrow. I got a Strep B infection and that is how I first got sick and they discovered I had MM. I went from jogging 3 miles in 33 minutes one morning to being flat on my back that night. I have never been the same since 10/4/05. Since then I have not walked or moved around like before. My body has been either weak or sore since 10/4/05, which I still find strange. I know other people with MM and they move about like normal and many still work. I was told my MM is aggressive, so maybe that is the difference, I do not know.
Immediately upon my illness, I could not move my right arm/shoulder. They said I had plasmacytoma’s in my right shoulder, but that they are often hard to see when they’re in soft tissue. I was put on Thalidomide/Dexamethasone initially. This treatment seemed to fix my right arm/shoulder, thus within a month I could move my arm. At first I held it close to my body. I could not move it hardly an inch to even wash under my arm.
Then in 12/05, just a few months after first getting sick, my back hurt so bad that I nearly got crippled. I almost could not get out of bed one day. Xrays did not show anything, but due to my pain and immobility, my doctor admitted me in mid-December. MRI showed a lesion in my T-8. I had 10 radiation treatments and that got rid of the lesion, but I then had compression. I had kyphopasty and all seemed well. (kyphoplasty is similar to vertebralplasty except they put a balloon in the place, squirt in the cement to replace the compression or height-loss, then I think they remove the balloon…but you’ve got that cement.)
In April 2006 I had a SCT (stem cell transplant). Unfortunately it did not produce any remission whatsoever. My number more than doubled within 30 days of my SCT. I was put on Revlimid/Dexamethasone from 8/06 through 10/07. I responded very well to that treatment in that my numbers went way down to normal. They just started to creep up when suddenly I just could not take either the Revlimid or the Dexamethasone. In mid 2007 I did start having a more difficult time walking. I think that I allowed my doctor office to have me see this Nurse Practitioner (Julie) too much and she did not listen to my symptoms very well. Further, I think the doctors were somewhat careless in my treatment. Once my numbers came down within normal range, they should have immediately stopped or lowered my treatment due to the side effects. Julie ignored my complaints and acted like “that is just the way it is with steroids.” Well, no it should not be that way. I was losing ability to walk and I think it was/is “myopathy” from the Revlimid.
I really didn’t feel all that numbness at the time in my feet, but I was definitely starting to lose coordination and balance walking. I even got a cane. I think Revlimid can cause myopathy. One day I had a URI and one of the doctors wanted to see me. When he saw me walk he said “we need to get you off of the steroids…” blah blah blah. Julie goofed me up I think. Another thing is that I was seeing the BMT doctors. They specialize in the transplants. I don’t think they’re as good in maintenance.
This office was also going through a merger. It was initially the Kansas City Cancer Center-St. Lukes BMT where I was going. They did my transplant. In the middle of August 2007 they merged with Kansas University Cancer Center. KU Cancer Center is awesome. So I have been transferred to Dr. Delva Deauna, who specializes more in maintenance, etc. I transferred to her officially 1/17/08. She is busy, abrupt and I initially did not think I liked her. I have changed my mind. She is adamant in not over-drugging and treating you. She explains how you get so you can’t do the treatment due the side effects when you overdo it. Had I been going to her, I wonder if I’d be a bit better off. Probably not, quite honestly. But it does make you wonder. When I think back of how I’d tell Julie what I was feeling, I get frustrated at how little she responded.
Anyway, come October 2007 I got to a point where I just knew I had to stop taking the steroids and the Revlimid. I was actually ready to just deal with what happens with no treatment. That is how my body felt. No more. When I stopped the Revlimid (11/07) and Dexamethasone (10/07), I was still seeing the BMT doctors. By January 2008 I have been seeing Dr. D. I’m just on pain medicine and a few preventative things so far.
Based on my symptoms of neuropathy, pain, and then being weak and anemic, Dr. D. began ordering several tests: Bone Skeletal Surveys, colonoscopy, endoscopy, gi endoscopy, MRI’s, Iron absorption test, and lab work. Everything turns out OK, though the GI endoscopy had a faulty capsule, so there was no valid results. My lab work shows my M-spike rising, but it’s still OK thus far (as of 3/08).
But as you’ve read, something now is going on. I did change pain medicine in February however. I used to take Oxycodone 60mg two times a day. Because I had to go on Medicare D, I can’t afford to hit that donut hole. Then, the FDA is pulling back the generic Oxycodone (for Oxycontin) and I cannot afford the Oxycontin. I had to change to a cheaper pain medicine. Coincidentally when I started on the Morphine Sulfate in early March 2008, I’ve been feeling a numbness where I urinate. It very well could be due to the MS, but we do not know for sure.
Also beginning in March or April 2008, I began having more trouble walking. My legs are just very weak, then numbness began to gradually set in. Oh, and I’d complained of some upper neck and back pain. It was tolerable but there. But due to the creeping numbness and pain, Dr. D. ordered several different MRI’s.
One MRI showed that I had very little spinal cord opening in my neck—particularly between my C5 & C6. Dr. D commented that “no wonder you don’t feel good…” At the time I had a fusion operation on this, on 4/11/08, I was already beginning to feel numb in my right leg and foot very much and it moved to my left foot and leg within a few weeks.
By May 2008 I became weak enough that while I can walk, I can not walk far or long. I have lost lots of balance. One of my MRI’s were in May, just before I was to go on vacation with my sister. I somehow managed the vacation from 5/10 - 5/17. It was memorable with family but it was very tough. Upon my return, 5/17, I felt very ill. On the evening of 5/18/08 I went to the KU Emergency room. I was extremely nauseous, had a headache, and then there was that numbness. The emergency room doctor told me that the numbness was a “big red flag.”
I asked whether Dr. D. would know I was in the hospital and was told she would be informed. On Tuesday evening while in the hospital, I pulled my home voicemails and had received two phone calls at home from Dr. D. requesting that I call her “stat”, that she was concerned with the results of my MRI, and that she wanted to admit me to the hospital immediately. I never understand that call, as here I was in the hospital, and what MRI was she referring to? I don’t think she got into the hospital to see me until that Thursday. There is something about being “on call” in the hospital and working in the clinic, some policy or practice, as to why she didn’t show up immediately, I think. Again, I never quite understood the explanation from the Case Manager Nurse when I asked about Dr. D. For some reason I did not call Dr. D. immediately. I think this is because I assumed that they knew what they were doing. I was being seen by several doctors while in the hospital, too. In the end, Dr. D. became involved with all the doctors looking me over, primarily neurosurgeon’s and neurologist, but also oncolongist, hematologists, and internal medicine or whatever. I felt in extremely good hands.
In any event, I was a mystery and complication and I believe remain one, quite honestly. The doctors were educated on my history and also was able to get the files from St. Joseph Hospital to when I had radiation in my back. While in the hospital I had a couple of LP (lumbar puncture–where they remove spinal fluid and look for infection, etc.) tests, a myelogram where they put fluid in your spinal cord. I don’t know the difference between the results of a myelogram versus the LP—other than in one you remove spinal cord fluid and the other you inject fluid into the spine. I knew the difference when I was in the hospital, but I’ve now forgotten. I took notes, but I must have missed writing this down.
I also had a “fat pad” test. This is a test for Amyloidosis, where the abnormal proteins get into organs and tissue. I do not have Amyloidosis.
Then I had a PetScan and I think it shows contrast..like “hot” or “cold” spots. “Hot spots” would indicate activity, that is “tumor“. “Cold spots” would indicate dead tissue, or “dead nerve cells”. I had ”cold spot” at my T8.
So, the doctors pow-wowed. My symptoms seem to relate to my Thoracic area. The Dr. who did the operation on my C5/C6 wanted to ensure that my CADF (Cervical Anterior Disectomy Fusionn) operation was not responsible for any of this. I believe the Myelogram test is the test Dr. J. ordered to verify this. In Dr. J.’s opinion, he believed the operation was a reasonable success and not involved with my current dilema.
One thought was that I had damage in my T-8 from the radiation treatment I had in 12/05. Usually, if radiation is going to do damage, it is within a year. This is over two years, however. The radiation doctors from St. Joseph felt that my radiation was too low and little to cause damage. It was at 3.5 gray, 10 treatments (whatever all that means). Also, the thought was had the damage (this spot at the T8) been from radiation, it would be in the entire area I recieved radiation–which was at T7, T8, and T9. There is only one spot at the T8 indicating dead nerve cells.
So, the diagnosis, as best as the doctors can tell, is that I had a “stroke” in my T8. It is due to the radiation, but not direct damage from the radiation. So I’m thinking that perhaps the radiation weakens things or something. I do not know. The timing and the one spot just indicates it must have been a “stroke in my spinal cord.” I’ve been told this is irreversible. I’ve also been told we’re in “wait, watch, and see” as to if this will get worse. It may take as much as three months to see if it can get worse. One doctor said it will plateau and then won’t get any worse.
So, what is going on with me? I am quite honestly still confused. I think more than one thing is going on, but I can not be sure. I wonder if I have neuropathy, myopathy, and spinal cord damage amongst other things maybe???
I find it funny that if I got neuropathy from the Revlimid, why didn’t I have more severe symptomms back in 2007 before I stopped the Revlimid? My feet tingling/numbness/pins/needles did not start until March and April. As I type this out, perhaps it’s really all just this spinal cord damage.
One thing I know, God is in control and he can do whatever he wishes with me. For one thing, I am open completely to God, using me for His good purposes. I also know that if He wishes, He can regenerate my nerves.
One other thing to consider is my cancer. My numbers are creeping up. I do sort of wonder if the Myeloma is just in my back and perhaps in tissue or organs. I know the ‘fat pad’ test was negative, but maybe the MM would show different.
I’m not scared and I’m not losing sleep over it. My biggest concern is leaving a mess behind for family to take care of and also being a pain while being sick and exiting this world. I just want it simple when my times comes…for my family’s sake. That’s sort of why I wish my place would sell and that I could get all organized and in a nice little place. I’ll have everything all lined out and just enjoy life until the end. Period. Simple. Sounds morbid doesn’t it? I’m just realistic, that is all.
Am I scared at times when I think of it? Well, ya I think so. But I’m not one of those that needs or wants to hang on to this fleshly life at any cost. I want to enjoy it and every little thing while I’m here, but when my times comes, so be it. I love God. I know it’s all about eternity. And then, what about all that stuff you accept what you can’t control and all?
OK, so back to the point I am trying to make paragraphs ago: stimulated bowel movement. I’ve wanted to get you to ”the now”. So here I am with this new body and sensation. Some of this may change for better or worse. I have a numbness from the waist down, though I can still feel, it’s just numby/tingly. It’s slanted sort of in my hip area and often feels tight across my right hips. I figure it must be something with nerve endings. They are squirrelly things for sure.
Where I urinate is basically numb, but that can also be due to the pain medication. I still have control of my urinating and bowel movements, but I am weaker. Again, some or all of this coculd also be due to the pain medication. I can not feel myself have a bowel movement totally. I feel pressure down there. When I am done, I feel like I’m still in the middle of having a bowel movement for several minutes, I guess due to those “nerve endings.” When I sit down, I feel like I’m sitting “on something.” I do not mean to be gross or too graphic, and I will remind you I’m just trying to be blunt in case you find yourself in a similar situation, but I think that if I have the littlest bit of BM in or near my rectum, that I can feel it. It feels like I have a cantelope or something pressing down.
But there is good news in all this. One can adjust. First, you must use your mind and focus. You just have to accept and embrace it, or you can choose to fight it and make your life miserable. There are worse things to adjust to, but I must admit–this really is tough.
I have always been careful with medication. I never want to be dependent or addicted to something. I get frustrated when I perceive my sisters worrying about me getting addicted to pain medicine. (If you have pain from cancer, you need pain medication and you don’t get addicted when that is your purpose. It’s when you take pain medicine for other reasons that you get addicted.) So, this potential to get dependent on any medication is something I am very conscientious about. I have hesitated to take stool softeners because I don’t want to be dependent on them. However, I realize that it is very important to keep your bowels moving. And, even if I do get somewhat dependent on softeners, etc., well, that is my “new treatment requirements.” I realize that there are those that are paralyzed, etc., and things just have to be done.
So, I’ve been taking three Sennekots a day to remain soft. You can take up to 8 a day. I have been having bowel movements every day. But I have felt like it’s not enough. I eat a lot. I don’t think what is going in and coming out is balanced.
So yesterday I decided to do something a bit more aggressive. I added a “stimulant” to my day. I used Correctol, which I really like, it’s very gentle. It says you can take up to 3 a day. I took three, one at a time a few hours apart. Then I took one this morning just for good measure.
It worked very well. Again, I learned a lesson but it was not too awfully bad. :) In any event, I’m not sure if I’ll just take 3 Correctol’s every so many days or what yet, but I just know that I need to add the “stimulant” to my regimen. I see the neurosurgeon 6/26 and a neurologist 7/23. One or both can address what I need to do, as they deal with neurological damage.
So, I guess the point here is that (1) You can adjust to anything you want and (2) It is very important to ensure you are having healthy bowel movements every day if possible. *************** Today I used better judgment as far as whether to push myself or not. I had a routine follow-up eye doctor appointment scheduled for this morning. I’m still staying up too late at night due to being wound up over the steroids. I was once again up until 3:00AM last night. I was very tired this morning. I canceled and rescheduled my appointment. Good decision. Better yet is that it will give my body time to flush out the steroids. When I’m on steriods, my eye pressure increases plus it changes my eye sight. I need new glasses and I think it is best all the way around to delay this appointment. So I did. I did not push myself like the day I did when I got my handicap tags. But it sure is nice using those handicap parking spaces now. Very convenient.
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