New symptoms

About 3 weeks after radiotherapy, my dad finally could make do without the walker but still needed the walking stick every now and then. There was a new symptom though: pins-and-needles sensation i.e. the one that you get if you've been sitting in a cramped manner for too long. It lasted only for a few days though.

His back started to ache too, which he managed by taking paracetamol (increased until the max 6 per day). We were not too sure what caused it because it was confounded by the fact that his posture was compromised by using the walking stick continuously for two weeks (and only on one hand), before he switched to the walker upon the advice of the hospice nurse.

Another bad news: his CA 19.9 marker had shot up to 251 :(

On the next appointment date (on a Friday), the palliative care unit (PCU) specialist attended to my dad, followed by the oncologist. In summary,
  • The fact that paracetamol relieved his back pain could indicate cancer of the bone but on the other hand, there was no pain along his spine and so the PCU specialist was puzzled. Another possibilty was existence of swelling somewhere and that pressed on nerves causing back pain and the pins-and-needles sensation.
  • Prescribed Celebrex to be taken twice a day for 3 days, then followed by once a day and finally on ad hoc basis if the pain is gone. Cannot be taken for the long term as it's detrimental to the liver.
  • Ordered CT scan of the upper body and pelvic area to obtain clues on the cause of the back pain. Normally the waiting time at GH is 4-6 months and the shortest is 2 months if it's deem urgent. The oncologist indicated that it was rather important to know this asap so that in the event the scan shows something, the team can plan the next course of action. Hence, we chose to do this at Mount Miriam. Dad was given appointment the following week with the CT scan results. The specialist did indicate that MRI would be more accurate but didn't push for it and said we could ask Dr D's opinion.
  • Made appointment with Dr D on Monday to ask for CT scan and her opinion on MRI.
Here's Dr D's opinion
  • Back pain likely to be muscle pain.
  • Pins-and-needle in calves likely due to bone spur
  • Since PET/CT scan was done just over 2 months ago, highly unlikely a CT scan will show any difference. If a scan is needed, then better to go for higher level scan i.e. MRI
  • Still suggest to have biopsy performed on the 2 hard lumps on my dad's right side of his waist
So she arranged MRI scan to be done on the whole spine at Lam Wah Ee Hospital (LWE) on Wednesday. Meanwhile, she ordered kidney function test of which the results she would communicate to us via phone and faxed to LWE. Prescribed Norgesic (muscle relaxant) to replace Celebrex.

Conclusion of MRI report: cervical spondylosis with cord compression C3/4.
5 Responses
  1. William Says:

    Good that the source of the pain was discovered. But a different source of sensations and pains kinda muddles the situation a bit hor? Did the doctor suggest any stretches, therapies to ease aches from the spinal problem?

  2. Twilight Man Says:

    Honestly, it is quite common to see cancer patients suffering from severe back pain or dizziness but I do not know its real cause.

    I agree that MRI scan is definitely the best. My 89 year old uncle just had slurred speech suddenly and the doctor conducted CT scans on his head around the brains but found nothing. His son decided to get MRI scan where the scanner could search thoroughly by thousands of image layers. They found a huge tumor pressing his brain which was removed during surgery. The tumor was tested positive & cancerous which is at advanced incurable stage. This woke me up about CT scans!

  3. Jaded Jeremy Says:

    William, Twilight Man,
    Will post update soon-ish. Thanks for sharing/asking.

  4. Anonymous Says:

    A classmate of mine suffers from cervical spondylosis with cord compression. Sometimes she could barely walk. She has tried all sorts of treatments: PT, acupuncture, meds; last resort would be surgery. Since surgery does not guarantee cure (might cause paralysis), she is holding off.

    PCU is supposed to give patients comfort and quality of life. I could be repeating myself here because I saw my earlier comments did not get posted since I did not click on "Anonymous." There is a case here when a person's father was having a terminal illness, and was advised to give up smoking to lengthen his life. The daughter took away his cigarettes. In hindsight, she regretted, because it did not prolong her father's life by much, and he suffered a terrible cigarette withdrawal syndrome. Looking back she said she would have allowed him to smoke all the cigarettes he wanted. SR

  5. Jaded Jeremy Says:

    It's a difficult choice and hindsight is beautiful.