July 7, 2009:
Bad news. For the past four weeks or so, I've felt an uncomfortable strain in my right shoulder as if I had pulled a muscle. On Monday evening, the pain became so intense that I walked over to the Emergency Room at Davies Hospital. After an X-ray and a CT scan and a wait of five hours, I was told that the reason for my distress was that there is a tumor in one of my ribs which has fractured the bone. Until that moment, I had no idea that there was any bone involvement other than the metastasis from my pelvic sarcoma into my pubic bone. So this is a whole new, and scary, development. The pain was severe, I gave it an 8 on a scale of 10. Most difficult was that to ease the pain, I had to hold my right arm straight up, then bend it at the elbow so that the palm of my hand rested along my spine. I was told by a little old lady at the hospital that I had great range of motion. I growled back that I was in a great deal of pain.

Yesterday morning, Lisa Capaldini, my primary care physician saw me on an emergency basis. When I told her what was going on she smiled and said, "Oh, we'll get you through this." Note: this is superb bedside manner!! I was so distressed that I was worried about holding my arm over my head for the rest of my life; that's how much the pain had taken over. But my pain did not take over Lisa. No, no. First, a prescription of anti-inflammatories to calm down the inflammation around the fracture (that's what hurts the most). Then, double my pain patches from 150 mg of Fentanyl to 300 mg. She said it would take about three hours for the anti-inflammatory to kick in and about two days for the Fentanyl to take charge. During the time that the Fentanyl is ramping up, I am woozy, but lucid enough to type this blog. Also, as a right-handed typist (and right-handed everything else), the effort to make these keystrokes is uncomfortable but nothing like the agony I felt yesterday.

Many short-term changes to my life plans. I will not be able to take my trip to Portland this weekend due to the uncertainty of getting my pain under control. Driving with my right arm not fully functional is not something I want to try. Nor lugging a suitcase. Etc. I have to say, this is the biggest shock at the moment because I was really stoked about seeing many close friends on this trip. This shock helps to eclipse the larger shock of having bone cancer. That is a very large shock indeed. Lisa said that this tumor might be treated with radiation if it gets too difficult. And there are other options. I am just a day and a half into the diagnosis at this point, and Dr. Jahan my oncologist hasn't had time to weigh in on what to do. We'll see.

In the meantime, I am going to ask all of you to please not call and ask me how I am. I've just done my best to tell you that in this entry. As new info unfolds, I'll let you know and I will also let you know when it's OK to call me. I know that I need a couple of days to be stupified by double my pain management. You can always send me an email to express your thoughts. But for right now, please, no phone calls. I love all of you and I know that you love me. That connection is full and in place.