Paul's Heart

You can tell a decision that one does not want to make, when it is looked at as a decision between “the less of the two evils”.  This kinf of outlook is often given to political races as it is nearly impossible to find a candidate for a postition that meets 100% of your values.

Today is not a very good day for me health wise.  My back is acting up, and fatigue is kicking the crap out of me.  I knew this day would come.  I had a bone density scan last week and got the call Friday with the results.  As expected, my back has gotten worse, with my 9th vertebrae now suffering with osteopenia.  This is a change from the scan done four years ago, where osteopenia was diagnosed in L1-L4.  Last year my back also showed facet joint arthritis, perhaps the reason for the pain and shape.

Osteopenia is like the little sister to osteoperosis, bad enough to be called something, not bad enough to be called osteoperosis.  Osteopenia is still loss of bone density.  Translation, it is an increased chance of breaking a bone, especially in my hip, back, or legs.  From what I understand, the pain in my back does not come from the osteopenia, but rather facet joint arthritis which I am now just starting to read up on.

So, when you hear the word osteo, just like mentioning breast cancer, our assumptions go straight to a concern for women.  The truth is, men can develop both of these diseases.  In my case, there is a good likelihood that I could develop both due to cancer treatments.  The radiation therapy has increased my chances with breast cancer, and hi dose, extended use of prednisone is most likely the factor to the already diagnosed osteopenia.  So while treatments have their positive intended effects, there are side effects both short term and long term.  Now that I have a new diagnosis, that must be treated.

But the medication that I need to take, at the beginning level will only be equivalent to vitamin supplements.  Of course, that is possibly going to have side effects as I continue to alter the physiology of my body.  In this case, the two supplements, Vitamin D and OSCAL were to help boost calcium needed for bone support which I was now needing.  There is one major drawback with taking on all this calcium, kidney stones.  I’ve already told that story (see “Congratulations It’s A…” under the links at the top of the page), so this is going to be about the aftermath.

The hospital that helped me get rid of that pesky stone, screwed up, and did not test the remnants leaving it up to me to figure out what could have caused the stone.  All things considered, I blamed the supplements.  My dilemma?  I need to take those supplements to keep from being crippled by an increased chance of broken bones, but if I do, I can look forward to many more kidney stones.  To avoid the kidney stones,  I could end up incredibly hurt.

So following the release of my urologist, so too I made the decision.  There would be no more kidney stones.  I had to hope that my decision would be correct and there would be no further issue with my bones.  But a bone density scan to be compared with a scan done four years ago illustrate that I was wrong.  The osteopenia has continue to spread and worsen over recent years with the cessation of those supplements.  While I have not had any more kidney stones, it is clear what my doctor forewarned me, “it can be five years or twenty years.  It is a matter of your choices and how fast it progresses.”

This is not the first medical dilemma I have been caught in the middle of:

1)  treat and survive my cancer vs. potentially severe late effects even worse

2)  removal of spleen which was fully involved with my cancer vs. immune system permanently compromised with little certainty of protection

3)  carotid bypass due to conditions of carotids, risk of causing a stroke same as just allowing it to happen

4)  take calcium supplements to slow process of crippling or prevent the crippling pain of kidney stones

5)  to have a colonoscopy because it is my time vs. exposing an area of my body that has yet to be invaded and in 46 years, have not had an issue with.

The choice between the lesser of the two evils.  I have many more to make, some just as serious, and some a little on the lighter side.  But when it is looked at a between two choices we do not want to have, clearly it is something I would rather avoid all together.

Side effects of medications are perhaps the most confusing things we have to decide to follow through with.  Just watch a television commercial for a new drug and to cover the company’s ass you hear the following disclaimer, “may cause suicidal tendancies, high blood pressure, kidney failure, depression, stomach ulcers, and memory issues.”  But other than that, it is great.  You will not see me rush to the pharmacy counter I can tell you that.