Dr. Al Danenberg ● Nutritional Periodontist
August 19, 2019
My journey with aggressive multiple myeloma started with my diagnosis in September 2018. One fact, which defined the extent of my disease at that time, was that my bone structure throughout my body was riddled with holes. These lytic lesions were the direct result of the bone breakdown process from my bone marrow cancer. My weakened bones were subject to pathological fractures. “Pathological fractures” are caused by a disease, rather than an injury. Both of my previous setbacks were related to pathological fractures.
Recently, I learned that I have the acute potential for other pathological fractures – in the thigh area of my left leg and the humerus in my right arm. My oncologist ordered a PET/CT Scan about a month ago. He observed an expanding lesion in my left femur which was breaking through the cortex of the bone. Basically, this meant that I am in danger of my leg fracturing. My weakened femur may not be able to support my normal body weight. A fracture in my leg would cause severe pain. Also, there was a lesion that was expanding to a lesser degree in the humerus of my right arm.
After the PET/CT Scan, I scheduled two appointments – one with an orthopedic surgeon and one with a radiation oncologist. Both specialists said that there was no way to prevent another pathological fracture. The orthopedic surgeon suggested that a rod be surgically placed through my femur to help support my weight, but it wouldn’t prevent a fracture. The radiation oncologist said that radiation might help with pain but could make the femur weaker. Also, it appeared that the lesion in my humerus was not a great concern at that time. Since I was not having pain in the femur or the humerus areas at the time of the appointment, I elected to do nothing for the time being.
Meanwhile, my blood chemistries continued to show relative stability with some ups and some downs. And my oncologist, whom I saw after the bone scan, believed my current chemistries were not showing a spike in my bone marrow cancer. However, there were signs of slow deterioration in my bone structure.
3rd Serious Setback
Then, things changed. The week before Friday, August 9, 2019, I began to have sharp pain in my triceps and biceps of my right arm. The pain became severe. My right arm could hardly function.
I had new x-rays of my right arm on August 9th. The results showed multiple erosions of the humerus of my right arm and confirmed the worse – another pathological fracture. The radiation oncologist said that radiation would not stop the pain from the fracture area, but it might help relieve some of the pain from the lytic bone lesions. However, I am dealing with innumerable bone lesions throughout my body – all of which could become symptomatic.
The next stage of my journey is becoming clearer to me and my medical team. I will have to concentrate on pain management.
On Monday, August 12th, I enrolled for in-home hospice care for pain management.
From Me to You
I want to thank you for your empathy and support. I want to let you know how much I appreciate YOU. I also want to let everyone know that my unconventional approach to my cancer treatment has allowed me to live a quality life with dignity until now. That was, and still is, my goal. Certainly, I will continue with my integrative approach.
I know I have written about this over and over again. But it is important to remind you that I believe living without quality and dignity is not worth pursuing for me.
Knowing what I know now, I would not have treated myself any differently. I never would have accepted conventional treatment using caustic chemicals which might extend my life but would have destroyed my existing immune system. Again, my emphasis is to lead a quality of life. Longevity has never been part of my equation. I have no regrets.
If hospice can provide adequate pain management to the point where I can still function and write as I am doing now, you will continue to read what I continue to write.
However, I am a realist. I know I have a terminal disease.
 A PET/CT scan allows the radiologist to see both the anatomical structure and the metabolic functions of the complete body. It is perfect to see malignant masses and bone lesions on a cellular level.