Dr. Al Danenberg ● Nutritional Periodontist
June 19, 2022
Hang in there with me. I’m going through another type of pain that I am experiencing right now.
But first let me tell you, I am doing amazingly well – except for this pain. My mind is clear, alert, and active. I have a great attitude, and my nutrition is excellent. I even planned a surprise dinner party for my wife for her 75th birthday on 6/5/22. She had no idea. The tears were flowing. I was pleased. It was great!
Yet, I have new pain. And I always have been a wuss when it comes to pain.
By the way, here’s a little secret that you already may know – men do much worse than women when it comes to dealing with pain. And I can assure you, I am not an exception. I am a baby when it comes to pain.
But pain is real.
My Old Pain
In my Blog on 4/17/22, I discussed an incapacitating sciatic nerve pain which I had to deal with 24/7. The pain was a result of malignant plasma cells becoming active and concentrating in the pelvis around my left sciatic nerve. All of this was caused directly by a combination of severe side effects from my immunotherapy that compromised my body’s immune system. Immediately after that, I contracted COVID, which activated the malignant plasma cells of my multiple myeloma to create a mass in the pelvis where the left sciatic nerve exited to travel down my left leg. Continuous pressure was put on the sciatic nerve. The symptoms began in early February 2022, but the pain got progressively worse.
To rid the pain, my oncologist suggested 10 targeted radiation therapies directed to the affected area over 10 daily sessions. The rationale was that the radiation would kill the mass of malignant cells, but it would not treat the overall multiple myeloma. It was a targeted treatment to stop the excruciating pain. And it worked.
Treatment began on 4/4/22 and ended on 4/15/22. By Monday 4/11/22, the pain in my left leg was gone! That was awesome. I was a happy guy.
My New Pain
Here is a brief history of my new pain’s origin.
My diagnosis of IgA Kappa Light Chain Multiple Myeloma in 2018 included innumerable lytic lesions throughout my skeleton. In other words, my bones had many areas of internal bone loss from the activity of all the malignant plasma cells, which were eating away at the bone. This created very weak bones – like a person with severe osteoporosis. So, these weak bones were (and still are) susceptible to pathological fracture. That means that any normal twisting or bending could cause a bone to snap!
In 2019, I experienced my worse setback because of these fragile bones. While brushing and flossing my teeth in my bathroom, I twisted my body slightly to the left to throw away my used dental floss. Immediately, my right femur broke in half, and I crashed to the floor. I broke several ribs and snapped my right humerus in half. The damage was so severe, I was placed into a hospice hospital to die. But as you may remember, I recovered. I revoked hospice and went onto thriving. But I learned my lesson – my bones were fragile, and I always would need to be careful in the future.
And I have been diligent about not bending or twisting abruptly since then. I take my time to move my body. I am consciously aware and proactive.
This brings me to my new bone pain.
About 5 weeks ago, I started having back pain. But this pain didn’t stay in one place. It was around my rib cage in my back, then moved under my shoulder blades, and then traveled to my rib cage in the front of my body. Bizarre!
Eventually, the pain seemed to settle into the back of my spinal cord in the thoracic region and under the right scapula. It became stagnant and constant. At times it was piercing. Don’t forget, I am a wuss and hate pain. My wife can attest to the fact that I can be a pain-in-the-ass when I don’t feel well!
Ibuprofen and Acetaminophen just didn’t cut the sharp pain.
When I saw my oncologist on 6/7/22, he agreed that something was wrong. My blood work that day was relatively good but showed an increase in markers that indicated some bone activity was occurring. He ordered a Thoracic MRI for 6/16/22, which was the first available appointment.
An MRI (Magnetic Resonance Imaging) produces 3-D images of the body structures using powerful magnets and computer technology which can show the spinal cord, nerve roots, and the surrounding areas, as well as enlargement, degeneration, and tumors. He believed I had a pathologic vertebral compression fracture. I must have twisted or bent my body the wrong way even though I have been so careful in the past.
He also added Percocet to my pain medication regimen – a drug that I never wanted to take since it is a narcotic.
A pathologic vertebral compression fracture is the collapse of a vertebra, which is a block of bone within the spinal cord. Because of the effects of multiple myeloma, these fractures could occur from just a simple daily activity such as stepping out of the shower, sneezing forcefully, or lifting a light object. This could lead to severe pain.
Here is an x-ray of a typical vertebral compression fracture, where the RED ARROW points to the crushed bony structure:
Results of my Thoracic MRI
My oncologist called me on Thursday evening, 6/17, with the radiology report. Here is a summary of its findings:
- Pathologic vertebral compression fractures exist in a few thoracic vertebrae.
- Several masses of malignant plasma cells exist alongside the spinal column putting pressure on nerves.
Treatment Plan
First, outpatient treatment will address the pain caused by the malignant cells using image guided radiation therapy. This will destroy only the malignant cells responsible for the pain but will not treat the overall multiple myeloma. Then, if necessary, outpatient surgery may include a procedure called kyphoplasty:
- Image Guided Radiation Therapy
Image guided radiation therapy (IGRT) is the use of imaging during radiation therapy to improve the precision and accuracy of treatment delivery. Radiation therapy machines are equipped with imaging technology to allow the doctor to image the malignant masses before and during treatment. This allows more precise radiation doses to the tumor. Treatment will start with an appointment for measurements and then 10 days of consecutive radiation. - Kyphoplasty Surgery
Vertebroplasty is a surgical procedure usually done on an outpatient basis. It may be performed with a local anesthetic and intravenous (IV) sedation. Using x-ray guidance, a small needle containing specially formulated acrylic bone cement is injected into the collapsed vertebra. The cement hardens within minutes, strengthening and stabilizing the fractured vertebra. Kyphoplasty is a modification of this technique where a balloon is used to help guide the cement and to increase the height of the collapsed bone. The spaces created by the balloons are then filled with the cement.
My Expectations
I have been here before.
As I just described in “My Old Pain”, I had targeted radiation treatments to destroy isolated masses of malignant plasma cells, which were successful. Also, I had pathologic vertebral compression fractures in the past that were treated successfully with kyphoplasty.
I am scheduled with my radiation oncologist to begin radiation treatment on Monday, 6/20/22.
Once radiation is completed, the pain should be gone. If there is a need for the kyphoplasty procedure, it will follow.
And then, full steam ahead.
The bottom line for me is this:
I most likely will not cure my “incurable” bone marrow cancer. But I know that radiation treatment can stop the pain, which is my most difficult roadblock.
I’m not a miracle; I’m just a plain old guy who won’t succumb to the conventional medical norms. I will continue with my 11 Unconventional Cancer Protocols, which I have designed to enhance my immune system to be the best as it can possibly be.
I appreciate each one of you for reading this, for your constant support, and for the interest you have in my journey. I’ve still got a lot to share with others and to do for myself. After all, it’s been almost 4 years since I was given 3-6 months to live. I’ve made it through a broken femur, botched injection, fractured bones, and even the dreaded COVID. Each time, I managed to regain control of my health and THRIVE! This is just another bump in the road, and another opportunity to learn more about the body’s incredible ability to heal.
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