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.