Round Two: The Author Laces Up the Gloves When Cancer Demands a Rematch
by Steve Oppermann |
Editor’s note: Steve Oppermann is a retired federal employee and author for FedSmith.com. He has chosen to share this personal story in the hope that it will both inspire and help others who may be facing their own battles with serious medical issues.
Somewhere during a recent stretch in which I was on business travel for five straight weeks, my aging body broke down. The most likely culprit was accumulated wear-and-tear from 10 airline flights, eight hotel rooms, schlepping luggage and an overstuffed computer briefcase from place to place and standing up all day while conducting training. But whatever the cause, damage was done. If my body had been a car, I’d have put the hood up, turned on the emergency flashers, and walked away.
The symptoms were three-fold: a) one of the worst head colds of my life; b) pain in both shoulders, and 3) pain running from my gluteus maximus through both legs and down to my oversized feet. I could have handled one at a time, or even two, but the three health hits together took a toll on me both physically and mentally. In my first 24 hours at a Marriott in Bethesda, Maryland, I used an entire box of Kleenex in a futile effort to keep up with my runny nose.
On my last flight home from Dulles to Denver, my sciatic nerve was screaming, and I wasn’t far from doing so myself. I hoisted my posterior off the seat with my knuckles as often as possible just to take the pressure off for a few minutes, but that caused my shoulders to hurt. Tylenol, which usually works for me, and Motrin, which I only take when I have reason to believe there is inflammation involved, had no effect on the pain.
I was never so glad to have an airplane touch down on the runway. The walk through the airport took about three times longer than normal, but walking was far easier on me than the ride home from DIA. As fast as I could arrange it, I went to see both a “manipulative osteopath” (I think of him as a chiropractor with a medical degree) and two orthopedic surgeons, one a shoulder specialist and one who specializes in spine problems.
The spine surgeon and the osteopath both agreed with my amateur diagnosis that my sciatic nerve had run amok, but couldn’t pinpoint the cause. After x-rays were taken, the doctors were using terms that had never before been applied to me, such as stenosis, arthritis, and herniated disk. I started a course of physical therapy, going four days a week, with the prospect of an MRI if the problem didn’t at least start to get better soon. While I had initially been seen for the sciatic nerve issue, the pain in my shoulders, particularly the right one, quickly overtook it.
All of the symptoms improved greatly when I was given a “burst” of oral steroids. The morning after I swallowed my first 6 pills (the regimen goes 6,5,4,3,2, 1, then none), I felt great, running freely at our Sunday morning touch football game and pronouncing myself healed. Well, not quite. As one doctor had predicted, by the time I got to the 2, 1 and none stage, the pain had come back with a vengeance, and my right shoulder pain could reasonably be described as excruciating late at night. It was like the pain was waiting to pounce on me between 10:30 and 11 at night, and for a two-week period I never slept more than an hour at a time, roaming the house in an unsuccessful effort to find a more comfortable venue.
The shoulder surgeon who looked at my x-ray saw a bone spur in my right shoulder and after putting me through some range of motion movements, speculated that I could have a rotator cuff tear as well. Both he and the spine surgeon wanted MRIs to gain more specific information. The shoulder surgeon offered me steroid injections, but I turned them down, saying that I’d like to see if my first-ever prescription for vicodin would suffice. The first pill put my lights out in the afternoon but had no effect on the late-night pain. The next morning I called the doctor’s office and begged for the cortisone shots, which were administered in both shoulders that afternoon. That night, I was able to conk out for several blessed hours at a time, having learned the debilitating effects of sleep deprivation.
The MRI of my right shoulder showed that there was no rotator cuff tear, for which I was deeply grateful, only some tendon damage and some other wear-and-tear stuff. The surgeon concluded that I would probably have to have arthroscopic surgery on that should in the not too distant future, which was a far better scenario than rotator cuff repair.
To my surprise, and that of two different doctors, the spinal MRI didn’t show any pinched nerve or other impingement of the sciatic nerve; there were also no spine tumors, and just mild disk deterioration, so the source of the pain in my legs and feet remained a mystery. But the MRI did disclose a swelling about where my cancerous left kidney formerly resided, so the spine surgeon ordered a CT scan. The scan showed that the swelling was a mass of some kind. So, the films were sent to the surgeon who had removed my kidney in February 2008, and he ordered a CT scan-directed needle biopsy of that area.
That was on a Thursday, and the doctor said I should not take any more Motrin until after the biopsy. My body rebelled against the restriction, as I got stiffer and achier on a daily basis. By the time of my appointment at the hospital early Monday morning, I could barely walk from the parking lot to the door, and could not take my socks off or put the hospital socks on by myself. And when I had to move literally inches from the gurney to the table where the biopsy would be performed, instead of the usual two seconds it took me closer to five minutes.
When the procedure had been completed, I was allowed to take Motrin and was soon feeling better from head to toe. The biopsy confirmed the doctors’ suspicions that the mass constituted a recurrence of renal cell carcinoma, with the cancer cells having affected the lymph nodes in the immediate area of the former kidney. My family and I were not pleased to hear the news, and when we saw an oncologist, he used such scary terms as stage IV and “systemic.”
He immediately ordered a positron emission tomography (PET) scan, an imaging test which required that a small amount of radioactive material be injected via an IV. Areas of disease, such as cancer cells, show up as bright spots on the PET scan. The doctor also ordered an MRI of my brain. The PET scan showed no evidence of any cancer cells beyond those which had been detected via the CT scan-guided needle biopsy, which was great news, and the brain scan was negative. I told the doctor that for what I was paying, I demanded that they keep searching until they found clinical evidence of a brain.
In the narrative report of my abdominal/pelvic CT scan, the radiologist stated that the mass was “worrisome” for recurrence of renal cell carcinoma. Having read that, I did a lot of Internet research and learned that the Cleveland Clinic was the nation’s number one hospital for nephrology and urology, so I made appointments with an oncology department head there and a department chair for surgery.
I won’t know until we have completed the medical visits at Cleveland Clinic what my action plan will consist of, but the results of the PET scan, which showed that the cancer cells had not spread to any other organ, and the brain MRI, along with the blood tests – all of which came out normal – and the fact that the x-rays, MRIs and CT scans showed no other abnormalities anywhere in my body, have left me feeling very optimistic about my chances of a full recovery.
And I am very, very fortunate to have an extremely strong network of support among family, friends, neighbors and colleagues. My wife, Lynda, has been a rock, always looking and sounding confident and only letting tears form when she didn’t think I could see her. And our daughter Kris and her husband Jon, have gone beyond moral support to active enlistment of specific, incredibly well-qualified, medical professionals.
Dr. David Agus, head of a cancer clinic at the University of Southern California and the author of The End of Illness, a #1 New York Times best-seller, is an old friend of Jon’s family and will be monitoring my progress and getting all of the reports from the various attending physicians. Dr. Agus, a rock star in the medical world, is a close friend of the oncologist we’ll be seeing at the Cleveland Clinic and has another good friend who is a department head at the University of Colorado Medical Center. The latter has agreed to coordinate my Denver-based treatment.
While I have by no means enjoyed the ongoing pain in my shoulders and lower body – and have resented the fact that it has forced me to miss six straight Sunday morning touch football games – if I hadn’t experienced that pain I would probably not have gotten another CT scan any time soon. I had been tested regularly for three years by the urologist, starting with quarterly CT scans the first year after the surgery, and had then been referred to a pulmonologist due to small nodules in both lungs. That doctor had me tested via x-rays and CT scans for another three years (with one overlapping year between the two doctors), after which he declared the nodules benign and set me free.
So it’s on to Cleveland. We’ll try to check out the Rock & Roll Hall of Fame and to visit Lake Erie. I understand that at this time of year when the cold wind blows off the lake it’s almost like being in Buffalo.
I’ll develop at least one more article once we have a game plan in place and I have started receiving treatment. I will make observations about the medical processes I have been and will be going through, and about how well I have done (or not done) in asking the right questions and in taking responsibility for my own health and well-being. I hope some of that information will be useful to readers who have to deal with serious medical issues of their own.
© 2014 Steve Oppermann. All rights reserved. This article may not be reproduced without express written consent from Steve Oppermann.