Timeline:
5/22/17: On the flight back from Austin, TX, patient experienced severe back spasms. Could not bend, twist, or move back. Nothing out of the ordinary happened. Patient was carrying only a small carry-on bag that was tucked under the seat. No heavy lifting was done.
5/23/17: Went to Concentra urgent care for advice on back spasms issue. Was told to take 4 Advils and 4 Tylenol to help with the pain. When patient asked what could be the issue, the reply: “Don’t know, something musculoskeletal.”
5/31/17: Back spasms remained severe at the mid to lower back. Went to see primary doctor. Was recommended physical therapy. Was prescribed Cyclobenzaprine 5mg for 3 days.
6/19/17: Started physical therapy. Was told that there was a slight scoliosis and pelvis is slightly rotated. Patient was told that pain was caused by weak core and glutes and prescribed exercises to strengthen core and glutes.
7/29/17: Mid and lower back pain subsided but patient started complaining about very tightness around sacroiliac joint. Was told that sacroiliac joints can sometimes be stuck.
8/21/17: Sacroiliac joint was still having pain and tightness. Was recommended chiropractic.
8/23/17: Started doing chiropractic and physical therapy. No improvement.
9/19/17: Back pain increased accompanying with sharp shooting pain down right leg. Very painful when coughing or sneezing. Saw another healthcare provider at the same medical office. Was told to continue physical therapy and recommended quad stretching.
9/20/17: Chiropractor and physical therapist ordered x-ray.
9/22/17: X-ray
9/25/17: X-ray review showed compression fracture at L3. Chiropractor referred to orthopaedic surgeon specialized in spinal injury.
10/11/17: Appointment with orthopaedic surgeon where she ordered MRI imaging.
10/23/17: MRI scan
11/6/17: MRI scan review with orthopaedic surgeon. Radiologist report noted more than 50% height loss at L3 compression fracture, mild to moderate narrowing of central canal, abnormal bone marrow with loss of normal trabecular architecture in the sacrum, and abnormality in the femoral heads. Orthopaedic surgeon recommended steroid epidural injection to help relieve pain. Patient asked about the abnormalities noted in the bone marrow and was told that it was not her specialty so she doesn’t know.
Reason for L3 fracture:
Patient cannot remember a time in the past where there was an injury that could cause the fracture. Patient also cannot recall a time when back pain was excruciating.
Patient’s physical activities prior to 5/22/17:
- Ran half marathons
Ran obstacle course
- Weight trained at least 3 times weekly
- Yoga at least once a week
- Very active: hiking, walking, always moving
Patient’s current physical activities:
- Walking very slowly
- Sitting
Sometimes when pain is really bad at home, crawling
12/4/17: First appointment with Kaiser doctor. Got referred to Oakland spine center.
12/13/17: In so much pain, could barely walk. Went back to doctor to ask for more help. Doctor noticed that I lost a huge chunk of weight. Decided to order bloodwork to see what’s up. Bloodwork came back with anemia and other wrong stuff. More bloodwork were ordered. X-rays were ordered for the upper back because I also felt severe pain at the upper back. Turned out, I have at least 5 more fractures at the thoractic area. Body is definitely falling apart for sure. At this point, I also got CT scans done for my organs.
12/19/17: Appointment with spine orthopedic surgeon in Oakland. They were puzzled as to why I have such a fucked up spine. They gave me a back brace and a pair of crutches because I could NOT walk without severe pain at this point. Basically crawling everywhere. Had 15 vials of blood taken from me that day. Look at me and the vials of blood:
12/20/17: Bloodwork came back showing off the chart liver values and some nucleated red blood cells. Red blood cells when being made in the bone marrow will have time to mature and lose their nuclei before being released into the bloodstream. If peripheral blood are being found with the nucleus (nucleated red blood cells) this means something is serious wrong because the bone marrow is release immature cells. The hematologist office called and said I need to come in right away for a bone marrow biopsy which I did.
My body wouldn’t cooperate to get enough bone marrow samples so they had to have two doctors and poked me about 5 different times to get a measly amount of sample. Not even enough for anything so I was ordered to get more blood drawn. By this time, my two arms were basically poked to death. The bone marrow biopsy wasn’t as crazy as people said it to be. People said that it was super painful but it wasn’t. All I felt was pressure and I kinda got to watch the whole thing through a reflection of the fridge next to me. Maybe I’m hella brave but maybe the lidocain worked hella well.
12/21/17: Got a phone call from the hematologist office a bit after lunch. The news is that bone marrow cells were observed under the microscopes and cancerous cells were found floating in there. CT scans came back with tumors in both breasts and liver. By this time, I have MRI scheduled for the next Tuesday. The hematologist office said that the Tuesday MRI is too far away and they need MRI and breast biopsies right away. The fastest way to get MRI and biopsies done without having to make appointments and dealing with the holiday is to be checked into the emergency room. They have called ahead and let the emergency room knows that I’m coming.
I basically cried for a whole 2 minutes because I don’t know how else to react to the news that I have cancer besides crying. Priyanka was making me a grilled cheese sandwich with pear and gouda and I had to call him over to tell him the news. He said: okay, we’ll eat our sandwich and we’ll go. It’s ride or die from now and we ride this out. I called my family and asked them to come be with me. We ate our sandwich and drove to the emergency room.
At the emergency room, more blood were drawn and a lot of waiting. I have to basically stay put until there was an opening in the MRI center for me.
Finally, a spot was open and they were able to do ⅓ of the MRI ordered. I had to be admitted to the hospital that night so I can continue to wait for MRI openings and biopsy opening.
12/22/17: That morning, an orthopedic surgeon came to see me and told me that the reason I couldn’t walk because I have a partial fracture at my right femoral head. It’s not completely broken but a femoral head replacement surgery is in my future. I could opt to do it right away or wait and hobble around for a bit. I have opted to wait to figure out what else is going on with my body. There were more waiting and finally I was able to come in for the rest of the MRI scans. The total time spent in the MRI machine was roughly 3 hours. A lot of people dislike being in the MRI machine but I don’t mind at all. I find it somewhat relaxing and it was nice to be taken care of by the crew. They tucked me in and made sure that I was warm and comfortable. I spent most of my time in there mediating and taking naps.
After the MRI were done, they wheeled me directly to biopsy. Breast biopsies were done with lidocain (I love this shit) at both breasts with ultrasound guidance. It was really cool to be able to watch the biopsy being done and seeing the needle extracted the pieces through ultrasound. They biopsied three lumps on both breasts with 5 samples at each lumps (15 samples were taken total).
I was finally discharged.
12/27/17: I was assigned an oncologist and met with him. Pathology report came back. It is determined that I have breast cancer ER(+) that had metastasized to my bone, bone marrow, and liver.
Liver tumor is about 2.5 cm in diameter
Bone marrow has cancerous cells that took over the marrow causing it to be reduced. Because marrow is reduced, it couldn’t produce enough blood cells so I’m constantly tired and easily winded. If I just walk up one flight of stairs, I get super tired and have sit down to rest. If I stand long enough to take a shower, I get tired and I have lie down to rest.
Cancer cells in my bones are destroying the integrity of my bones. It also caused a lot of the calcium in my bones to leak out into my blood. This makes my bones super duper weak so that’s why I get a ton of fractures everywhere. That explains all of the pain in my body.
ER(+) breast cancer is caused by some breast cells overly expressing estrogen receptors (hence the ER) on the surface of their cells. ER receives the estrogen hormone which stimulate growth. Since they have extra estrogen receptors on the surface, they receive growth signal like crazy so they grow like crazy hence CANCER! The good news is that ER(+) tumors can be treated with hormonal therapy instead of chemo. Chemo is also another option that may or may not be used in the future. The systemic hormonal therapy can also treat the cancer cells in the bone, bone marrow, and liver too. I would also be get targeted radiation therapy in my spine to kill off the cancer cells there, then promote bone growth with drugs to stabilize my spine to prevent potential damages to my spinal cord.
However, since my bone marrow is diseased, I’m severely anemic. All of the cancer drugs and radiation therapy also will further suppress blood cell productions which will then making me even more anemic before I can get better. Of course, there is also a risk that the cancer will continue to spread to other parts of my body (lungs, brain, etc.).
12/31/17: I walked down the stairs, my right toes got caught in the carpet and I twisted my right leg. I heard a loud pop and scrape and the pain was so bad that I couldn’t even deal! I sat down, hoping the pain would go away after a while. After what seemed like forever, the pain still didn’t go away and couldn’t even move my leg. Priyanka called the ambulance to take me to the emergency room. My sister and my mom had just dropped me off in SF and were heading back to Sacramento were called back to meet me in the emergency room again.
The ambulance team were excellent, they were able to carry me downstairs in the exact same position I was in therefore minimized any pain. They were such cool people and I had the most pleasant ride (besides the crazy pain) to the emergency room. I found out that one of the medics grew up near the neighborhood I currently live in. It was so nice to see them. I thank them for working New Year’s Eve.
When I arrived at the emergency room, one of the patient coordinators recognized me from the last time. We had a good chat. I don’t know if it was a good thing or a bad thing when people at the hospital started recognizing me. They sent me to get x-ray right away. For the x-ray they had to straighten out my leg and it was the most painful thing I have experienced in my whole life. I didn’t cry though because I ain’t no wuss. In movies, when they show people with broken bones running away from zombies. They lied! It hurts like a motherfucker. The techs were so great, I thanked them for working New Year’s Eve.
I had to be admitted to the hospital waiting for surgery the next day. The whole time, whenever I have to pee, I peed in a bedpan. I press a button, a nurse came in, I rolled over on my good side and they slipped a bedpan under my butt. I peed freely then pressed a button again and they came by to get the pan. My mom then wiped my butt like I was a baby again. Oh, they totally cut off my pants in the whole process so I was naked the whole time. It was kind of liberating.
The whole night, they kept saying that the orthopedic surgeons are reviewing my case and will come to talk to me. No one came to talk to me. I kept insisting that I need to talk to my oncologist before committing to any surgery since I’m on a bunch of drugs and stuff. They all said that no surgery would be done without my consent. My poor family again have to the spend the night in the hospital with me. My mom continued to wipe me down every time I pee.
1/1/18: Happy New Year. The new shift nurse came in to take my vitals and send me off to the operating room. I said: da fuck? No one came to talk to me about my conditions and they assured me that I would get a chance to talk to my oncologist before going ahead. They got freaked out because I, up to this point, was pretty pleasant. They finally sent someone from orthopedic up to talk to me. Since I was wearing disposable contacts the night before and Priyanka hasn’t come back with my glasses, I was basically blind so I couldn’t review any x-ray and I couldn’t move anywhere. The orthopedic resident was able to draw me a very nice drawing on a piece of napkin of my condition. My partial fracture became a full fracture and the femoral head completely broke off and shifted down. They were able to get my oncologist on the phone too and he told me which medication to stop for the surgery.
Then I got wheeled off to the OR at around 10 am.
In the OR, I met the surgeon and he explained to me the exact procedure, what they will be doing and what to expect. I felt good. I would be getting propofol so I could sleep but I would be getting spinal anesthesia instead of general anesthesia.
I received the propofol and got knocked out immediately. They didn’t even have to make me count backwards.
At some point, I woke up because I thought we were done so I said: GOOD AFTERNOON!!! I felt a hand on my face and a voice saying: Just go back to sleep. So I thought to myself: I guess we’re not done then. And I went back to sleep.
When I woke up, I was already all cleaned up and bandaged up. I was put through recovery for a while. They gave me apple juice and make sure I was comfortable. The nurse was worried that I wouldn’t be able to pee due to the anesthesia so she did a bladder scan. She gave me a bedpan and asked me to try peeing on my own or else she would need to place a catheter. I did not want a catheter placed so I peed like a champion. Like a freaking champion!
Unfortunately, by the time I fully recovered from the surgery, the physical therapist has already gone home for the day so I had to stay in the hospital an extra night. That night, I was able to get up and use the bathroom with the help of a nurse and my mom. Still couldn’t wipe my own butt so my mom had to do it for me. She said that I’m super stinky because I’ve been peeing myself for two days and no shower. I waited all morning the physical therapist to get to me. When she finally got to me, I couldn’t stand without getting super light headed. They did some blood drawn for my CBC.
As it turned out, I have lost some blood during surgery and combining with the fact that I started out anemic already didn’t help. A normal female hemoglobin level is supposed to be from 12 - 15 g/dL but mine was at 7 g/dL. So I had to get a blood transfusion.
This was when I found out that my blood type is actually an O+ instead of the B+ I always thought I was!!!! Both of my parents are B+ and I guess they’re both BO and they didn’t know. We called my dad and jokingly told him that I’m not really his kid.
Well, it also took forever for someone to get to the blood bank to grab me a unit of blood too. So I didn’t get my blood until 3pm. Thank you to all of those who donated blood. You helped save me!
Around 5 pm, blood transfusion was done and physical therapist came to see me. We practiced walking with a walker, walked up and down the stairs with a pair of crutches.
I finally got discharged a bit after 7.
When the nurse came to remove my IV catheter and she used to big of a piece of gauze and tape so there weren’t enough pressure on my IV opening. I was bleeding through and the blood got trapped under the piece of tape into basically a blood pocket. My mom noticed it and she was like: oh no!!! I saw and quickly bent my arm to place pressure on the opening, it popped the blood pocket and I basically sprayed a bunch of blood across the whole room.
Finally made it back to Priyanka’s place and my mom gave me a sponge bath. I was able to finally brush my teeth and wash my face after what seemed like a month. It was the best feelings in the world, I tell you! Then I promptly fell asleep after my family left.
My family and Priyanka was there throughout the whole ordeal and I’m so so so so thankful and grateful for them. I wouldn’t know what to do without them around. It made me beyond happy even with all of the cancer and the surgery and the pain. Not only that, my friends were all there for me via text and I have to say that it made me feel like I was the luckiest person ever!
1/8/18: Finally met with the radiation oncologist to map out my treatment for my spine. I will be getting treatments at three separate sites (lumbar, thoracic, and base of skull). Oh by the way, I started getting numb around my chin area and this is due to the diseased bone right beneath my skull. Each treatment site will take 10 sessions so roughly two weeks to complete. The main side effect would be fatigue. So I’m taking my good days as small victories since I know fatigue will be in my future for at least the next 6 weeks.
1/9/18: My original surgery dressing had came off. The incision site looks great. No redness, no swelling, no draining. I have since able to get in and out of bed by myself. Go use the restroom by myself. I even walked the dogs to the end of the block today without help of crutches or walker. I even walked from the car to my MRI scan today too!
Everyday, I continue to improve bit and bit and it’s making me so happy. Just a bit more than a week ago, I couldn’t walk without the help of crutches or walker and was in so much pain. I haven’t been able to stand up by myself for so long. Every little improvement was celebrated.
Overall, I know I have cancer. I have learned about cancer in the past. I’m not ignorant about the illness and whatever else is going on in my body. Sometimes it does feel like my body is falling apart everywhere. However, my mental state is very stable and happy. I feel beyond happy to meet new people who are so kind to me and my family. I got to actually spend more time with my family. Seeing them staying up with me, sleeping in chairs at the hospital with me, and just taking care of me makes me so happy to know that they’re there.
Priyanka has been with me every moment of this journey and he has done everything for me and I mean everything. He helps me celebrate all of my small victories and think through my treatment plan.
My friends have been so so so so so supportive that I don’t even know how to express how lucky I feel to have them in my life. I don’t think I have the adequate vocabulary to really speak on how happy everyone has made me feel.
So I want everyone to know that I so appreciate you all and all that you have done for me. I don’t know what I did to deserve it but your love for me is most definitely felt. I hope to get well one day (not soon because I know it would be a long journey) and get to spend more time with you all. I have spent a total of maybe 3 minutes crying about my conditions and pain but I have cried many many many happy tears witnessing your kindness towards me and my family. Knowing that excellent people like you exist in the world filled me with so much joy and happiness that I can’t contain.
So I want you to know that I am happy and positive and doing wonderfully mentally even though my body is not doing the same. I love you.
