Bee’s Knees 3

This is a continuation of an ongoing knee issue.  It started with Bee’s Knees and went on to Bee’s Knees Continued.  I’m hoping to end my knee pain in the very near future.

A quick knee recap:

From https://maryomedical.com/2013/02/18/icy-days-and-mondays/ January 28, 2013:

 I checked the weather and found that school was starting late because of icy conditions.  I put on boots and took the dog out.  It seemed to be raining – if it’s raining, it must be warm, right?  So I didn’t really pay attention (and I had other things on my mind!) and completely missed seeing the black ice.  Next thing I knew, I had fallen on one knee, my cellphone in my pocket bruised my other thigh and my left arm hurt where I’d reached out to catch myself.

From https://maryomedical.com/2016/02/28/bees-knees/

January 2016.

I fell in the bathroom in the middle of the night and hit my left knee on the tub. I used a brace for a few days and it seemed better.

Around January 27-28, 2016, I was in Walmart and had to get a produce bag that was way over my head.  I had to stand on tiptoe…and my knee felt like something ripped.  Thankfully, I had a cart available to use as a temporary crutch.

Got home, used the brace, took Tylenol but the pain got worse.

Thursday, I drove home from choir at church.  My car is a manual so the act of using the clutch, extending my foot that way, made everything worse again.

Friday, we went to the Limp-In Clinic in Greenbriar.   That doctor was going to prescribe Cortef or NSAIDs but I couldn’t take either due to my history of Cushing’s (Cortef) and kidney cancer (NSAIDs).  He prescribed Vicodin and sent me for an x-ray.

January 31, 2016, I got very itchy, presumably from Vicodin so I stopped that and started taking Benadryl for the itchiness.

February 2, 2016, I went back to the clinic for the results of x-rays and  I mentioned the itchiness.  Since I have very limited meds available to me, he recommended an Orthopedist.  I called him when I got home and he didn’t take my insurance.  I tried another doctor who supposedly took my insurance but they didn’t.

February 7, 2016, I really needed the sleep so I took half a Vicodin.  No pain and no itching.  HOORAY!

February 8, 2016, I saw my regular doctor.   She thinks it’s a possible “lateral collateral ligament vs meniscus tear”.

I was surprised that she thought my knee was swollen but one of my therapists showed me later that it was.

She referred me to Physical Therapy (PT) and prescribed Ultram. As of this writing, I haven’t used that yet.

February 11, 2016, 8:30 am  My first appointment with PT.  Since my blood pressure was high, we mostly did assessments.  I had a main therapist and a student. They had to use 3 types of BP machine to do this.

I bent my knee and they took measurements with a caliper.  I lay on my front and they manipulated my knee to see what happened. They also concluded that it was a lateral collateral ligament.

A suggestion – to rest my foot on the walker without the brace and see if gravity helps my knee straighten out.

After this, there was more pain than before but I know this is the right thing to do.

February 13, 2016.  My leg feels a bit better.  I had the brace off last night and almost straightened my knee out.

Somewhere in this period, I learned how to manually move my kneecap (patella) around.  I saw my day 1 therapist again and he said my knee was angry.  Swollen, angry, whatever.  I just want a normal non-hurting knee!

One of the therapists had me doing a stretching exercise and my hip was out of kilter (everything is attached!) since I’ve been walking with my knee bent.  So she manipulated that back into alignment.

February 22, 2016, A new-to-me therapist had me do an exercise with a basketball under my knee, pointing my toe to the left.  I didn’t remember doing that before but she said I had.  Hmmm…

That hurt too much so we moved to a foam roll under my knee.  It was still uncomfortable but I did it, a bit too much, apparently.

Turns out this exercise hurt my “VMO”, which is short for Vastus Medialis Oblique.

“This is the most important quad muscle and arguably the most responsible muscle for knee stability. The VMO’s main function is to control knee extension…” 

February 25, 2016,  My VMO pain still hurt.  I told my regular therapist about it and she worked on it some.  She concurred that my knee was swollen.

February 26, 2016,  I went all day with no brace at all!!  A bit of pain but manageable.

February 28, 2016, and I haven’t worn the brace since the 27th. I still need assistance to get up from sitting but I can see huge improvement.

I still have 6 more PT sessions, finishing on March 16, but I’m really impressed with what they’ve done for me.  I still have twinges of pain and I don’t plan on stepping on tiptoe anytime soon but I can tell I’m on the right track.

March 8, 2016 at 9:48 am

Physical Therapy is sapping what little energy I had 

 I can tell it’s working but I am even more exhausted all the time. I’m taking extra Cortef but it’s not enough…

From https://maryomedical.com/2016/05/05/bees-knees-continued/ May 5, 2016

My left knee is still bothering me, even after doing Physical Therapy since January. <sigh>

It seems to get better, then something happens and it’s back to pain again.  When we were on a trip to New York a month ago, we walked a lot and climbed so many stairs, I had to buy a new brace.

Today is supposed to be my final PT but I don’t think I’m ready.

When this clinical trial came to my email, I just went through the whole survey for this but there was no doctor nearby:

Osteoarthritis Research Studies. Knee and hip arthritis studies enrolling now. No-cost medication. http://curec.lk/1VL5hu9


Fast forward to September 5, 2018

My knee has been bothering me off and on for a while.  I’ve been taking water aerobics and was careful not to do anything that would hurt my knee.  The hot tub afterward was a great place to aim hot water jets at my knee – that would numb any pain for a while.

I realized that the neoprene braces were making me itch so I actually found one with no neoprene – Hooray! “All BioSkin material is hypoallergenic. Latex free and Neoprene free.”  Hooray again!

This last week or so, the pain has been getting worse again so I decided to try a new doctor.  This one seems like maybe – just maybe – he’ll fix things.

He said: “Your previous knee injuries made sense for pain but this spontaneous onset of medial knee pain is a bit strange.  I can only do a limited examination due to the pain and difficulty bending, but it seems to be over the distal insertion of the VMO (quadriceps muscle) with possible inclusion of some joint line tenderness on that same side.

I’d like for you to use ice packs in your knee brace at least three times a day with the goal of calming down the inflammation.

My goal with getting you to sports medicine next week is to re-evaluate it, hopefully with better ability to examine and flex. It may need ultrasound evaluation and/or steroid injection. Since you cannot take NSAIDS, I suggest trying the Ultram that your previous doctor gave you so you can sleep.”

So, next Wednesday, I have an appointment with sports medicine – I might be moving forward. Or not.

 

New treatment lowers risk for death from aggressive prostate cancer by over 70 percent

Some of the 165,000 U.S. men who are estimated to receive a new diagnosis of prostate cancer this year will develop resistance to hormonal therapies for the disease, but a new study by a doctor now at Northwestern Memorial Hospital points to use of an existing drug to help treat them.This kind of aggressive cancer has challenged doctors, as effective treatment to improve outcomes for these men hadn’t existed previously.

But a clinical trial led by Dr. Maha Hussain, now an oncologist at Northwestern Memorial, showed that taking a drug, enzalutamide, resulted in a 71 percent lower risk of cancer spread or death, compared to those taking a placebo during the three-year trial. The patients involved all had prostate cancer that hadn’t spread but that also had not responded to hormone treatment.

Men taking the drug also had delayed cancer reappearance for almost two years.

Read the entire article at New treatment lowers risk for death from aggressive prostate cancer by over 70 percent, study finds – Chicago Tribune

National Cancer Survivor’s Day

 

 

Observed annually on the first Sunday in June, National Cancer Survivor’s Day has been set aside to “demonstrate that life after a cancer diagnosis can be a reality.”

Each year on National Cancer Survivor’s Day, events and celebrations are held and hosted around the United States by local communities, hospitals and support groups honoring cancer survivors.  Events may include parades, carnivals, art exhibits, contests and testimonies. President George W. Bush and the National Cancer Institute director each included a commencement at the 2008 celebration.

 

So today is my day and my mom’s day and countless other people’s day.  I’m a kidney cancer survivor – 12 years now!

My mom survived colon cancer TWICE

My sister-in-law survived breast cancer TWICE

My DH survived melanoma and is working hard at surviving prostate cancer.

It hasn’t been all good though.  There have been many more in my extended family who did not survive, including my dad and my aunt. 

 

Congratulations to the survivors on this special “Who Knew” holiday, National Cancer Survivor’s Day

 

 

Unlucky Women! Belly fat tied to lower kidney cancer survival odds in women

Thanks to Cushing’s, I have (and had!) a lot of this.

Belly fat reduces a woman’s chances for surviving kidney cancer, but not a man’s, a new study suggests.

The study included 77 women and 145 men with kidney cancer. Half of the women with high amounts of belly fat died within 3.5 years of diagnosis. Meanwhile, more than half of women with low amounts of belly fat were still alive after 10 years.

Researchers at Washington University School of Medicine in St. Louis found no link between belly fat and men’s kidney cancer survival.

The findings suggest kidney cancer develops and progresses differently in men and women, the study authors said.

“We’re just beginning to study sex as an important variable in cancer,” study senior author Dr. Joseph Ippolito said in a university news release. Ippolito is an instructor in radiology.

“Men and women have very different metabolisms. A tumor growing in a man’s body is in a different environment than one growing inside a woman, so it’s not surprising that the cancers behave differently between the sexes,” he explained.

Excess weight is a major risk factor for kidney cancer, but does not necessarily affect a patient’s chance of survival. This study suggests, however, that the distribution of body fat affects women’s survival odds. But it does not prove a cause-and-effect relationship.

“We know there are differences in healthy male versus healthy female metabolism,” Ippolito said. “Not only in regard to how the fat is carried, but how their cells use glucose, fatty acids and other nutrients. So the fact that visceral [belly] fat matters for women but not men suggests that something else is going on besides just excess weight.”

This line of research could lead to better ways to treat women with kidney cancer, Ippolito added.

The report was published online recently in the journal Radiology.

More information

The U.S. National Cancer Institute has more on kidney cancer.

From https://www.upi.com/Belly-fat-tied-to-lower-kidney-cancer-survival-odds-in-women/2511523328151/

New Clinical Trials for Kidney Cancer

Two new clinical trials for kidney cancer are available at Lehigh Valley Health Network through its partnership with Memorial Sloan Kettering Cancer Center, giving patients options for experimental treatment and participation in research that advances kidney cancer treatment.

The immunotherapy trials test combinations of drugs that cut off blood supply to tumor cells and help the immune system find and fight cancer cells.

A decade ago, late-stage kidney cancer patients had a small chance of living past a year after diagnosis, said Dr. Suresh Nair, medical director of LVHN Cancer Institute.

“The amount of progress that’s happened in the year is staggering,” he said. “Kidney cancer has probably progressed the most among all the cancer areas in the past year.”

On Thursday, about 30 patients made it to their second annual celebration of advancements in kidney cancer treatment. The event, which was sponsored by the Andy Derr Foundation for Kidney Cancer Research and hosted by LVHN and Memorial Sloan Kettering at Lehigh Country Club, also featured a talk by leading kidney cancer doctor and researcher Dr. Robert Motzer, an oncologist at Memorial Sloan Kettering.

Kidney cancer research had a major breakthrough in 2006, when a Pfizer drug sunitinib won approval from the Food and Drug Administration, Motzer said. The drug cut off blood flow to tumors and prolonged life for late-stage kidney cancer patients.

Since then, survival rates continue to climb due to new generations of sunitinib, including one used by LVHN doctors called cabozantinib, and advancements in immunotherapy, which boosts the immune system to fight cancer.

But there’s a lot more progress to be made.

“That’s why efforts like your own are so important,” Motzer said at LVHN’s event. “That’s what gets the work done.”

Every year, more than 37,000 men and 21,000 women get kidney and renal pelvis cancers, according to the U.S. Centers for Disease Control and Prevention, and more than 13,000 die.

LVHN offers six clinical trials for kidney cancers, including the two newest.

New treatments give patients such as Lackawanna County resident Arlene Townsend a second chance at life. She’s participating in an LVHN immunotherapy trial launched last year.

Before her diagnosis, Townsend, 38, was easily irritated and didn’t have any passion for her job or life.

“It use to be get up, go to work, come home, make dinner,” she said. “It was kind of just going through the motions.”

She had to develop a positive attitude to cope with the physical and emotional toll of her late-stage kidney cancer, which had spread to her bones, lung and the lymph nodes around the heart in 2016, she said. Since her diagnosis, she found a passion for refurbishing furniture, let go of her cynicism and found happiness in life’s small moments.

“If I’m driving — it sounds silly — I notice the clouds,” she said.

“You don’t realize how many great things you have in your life until you think you’re not going to have them anymore.”

The change was so apparent that her husband noticed.

“He thinks I’m much happier,” she said.


CLINICAL TRIALS

Lehigh Valley Health Network and Memorial Sloan Kettering have partnered to bring new cancer treatments to the Lehigh Valley.

What is a clinical trial: A study involving patients who volunteer to receive new medications or treatments under evaluation.

Who may participate: Criteria are unique to each trial but often are based on age, gender, health and medical history. They are designed for participants most like those who will eventually receive the new drugs.

Source: Lehigh Valley Health Network

More information: At lvhn.org, search “clinical trials.”

From http://www.mcall.com/business/healthcare/mc-nws-biz-clinical-trials-kidney-cancer-20180406-story.html

Doctor Offers Cutting-Edge Treatment

EUGENE, Ore. — The Willamette Valley Cancer Institute and Research Center offers a cutting-edge treatment to help patients with prostate cancer improve their quality of life.

When William Marshall was first diagnosed with prostate cancer in 2016 he said he was concerned about how traditional treatments could impact his life. He said he went to a support group and saw people wearing diapers and colonoscopy bags and worried he wouldn’t be able to do many of the things he enjoys like hiking, hunting, and fishing.

Then he saw a commercial about a new treatment the Cancer Center was offering.

The treatment is called SpaceOAR which is essentially a gel that is put between the prostate and rectum that separates the organs. Its designed for patients who use radiation to treat their prostate cancer. By separating the organs, the gel helps reduce the amount of radiation to organs surrounding the prostate. The gel is temporary and will only stay in the body for about three months before it dissolves.

Dr. Thomas Sroka, a radiation oncologist with the Cancer Center, said inserting the gel is a minimally invasive procedure that can reduce long-term side effects like chronic pain, irritation, diarrhea, and bleeding.

“Radiation treatments are already effective at curing prostate cancer, but this is really something now that is focused on just improving the patients quality of life during treatment and after treatment,” Sroka said.

Sroka said patients getting the treatment done are often able to avoid the negative side effects.

Marshall said the treatment changed his life and helped him manage his cancer.

“I’ve been able to do exactly what I have my whole life without any second thoughts about that cancer that I have that I now believe is gone,” Marshall said.

Marshall said now he wants to make sure other people dealing with similar circumstances know the treatment is an option.

Currently, Sroka is the only doctor in Oregon who can perform the procedure. However, he said Medicare has now recognized the treatment and he expects more doctors to become certified.

From http://www.kezi.com/content/news/Willamette-Valley-Cancer-Institute-and-Research-center-offers-innovative-treatment-for-prostate-cancer-patients-478918853.html