Friday, February 19, 2010

Friday report

I'll work backwards today, first I'll write about normal life stuff, then cycling, and finally the long awaited treatment plan.

My knee hurts. I've been off the bike since sunday and I'm still having some pain when I walk down stairs. The physical therapist thinks it is due to a muscle imbalance that causes my patella to be pulled to far laterally (to the outside) and then track off of its normal line...which causes inflammation and pain. I usually lift weights throughout the off season and I've found that to be extremely helpful in avoiding problems like this. This year, after I found out about the vertebral met, I stopped lifting due to concerns of unnecessary spinal loading and instead starting riding 12-18hrs/week. It felt great for my mind and for awhile, my body. But over a month, with my tendency to push too big of a gear than what is necessary, I ended up with a muscle imbalance and pain. I'll take next week off as well, which will take me out of Froze Toes :( and see how it feels.

Wait a minute, that was all about cycling not normal life?! Oh well. Onward.

Family life and work are both pretty awesome right now. Maggie has been a hero the last few weeks and Cassidy is a riot. My research is getting ready to ramp-up and my volunteer work with the children's oncology floor is taking form.

As for the volunteer work, I'll be on call to them and available to come in whenever they have a patient who they feel would benefit from talking to me. The classic kid would be a 14 year-old kid who plays a sport and now thinks his life is over due to his diagnosis. I come in and talk to them about the importance of continuing to do what they love and tell them a bit about my story.

Later in the spring, once the H1N1 thing has calmed down, I'll bring some bikes in and lead a program about bike safety, cycling, and physical fitness in the face of chronic disease.

Ok, treatment stuff. Everyone is in agreement that a procedure called steriotactic radiotherapy will be the best thing to treat the 1.5cm x 1.4cm nodule of blood and thyroid cancer in my 5th thoracic vertebrae. Basically they'll stick a needle into the bone and then zap it. Pretty god-damned scary if you ask me.

The 'when?' of the treatment is the big question right now. In January, the nodule received a hefty dose of radioactive iodine, a known cytotoxin to all cells thyroid. So there's some reason to think that if we wait a little while, the thing will at least decrease in size. Therefore, allotting a smaller dose of the big-bad needle radiotherapy. 3 months (April) has been the time thrown out there. But in the past, I've always heard it takes around 6 months for the affects of radioactive iodine to become apparent, so I don't quite understand why, if we're going to wait, we don't just wait 6 months (July).

The 'where?' is at least a bit comforting. I'll for sure get that treatment in St Louis at Wash at least they'll be friends and family around (and I'll be right across the street from Forest Park so it'll be easy to dis-obey any doctors' instructions about not riding my bike, although I probably won't actually have many restrictions at all). Maybe I'll commute to the hospital.

In summary:
-needle in back in either April or July @ Wash U
-Knee hurts, I want it to stop
-Family and work rock


Black Matt said...

Hey buddy, glad things are on the up in some aspects and that you have a plan in place for others. I'm sure you know by now I hope for the best for you.

As for your knee, I'm curious if you've ever had a thorough fit on your bike. If not, it's likely that the issue is not pushing too big a gear, but improper positioning. There are a number of highly skilled fit technicians in St. Louis (and Columbia, I'm sure) and if you talked at length to any one of them and had them assess your position, they might be able to solve your problem once it's healed.

Are you still coming in this weekend? We should get together if you are. Take care of yourself.

Martin Lang said...

it could also easily be a big gear. easy solution is limit your gearing. Don't ride anything bigger than a 39x17. That's a common gear to limit to for easy days. I think it could be a lot to do with cleat position. Especially if you're riding a road bike with different pedals and shoes now. I'd think it'd be hard for a pt do diagnose the problem without seeing you on the bike.