My Physical Therapist Was Right (Darn It)

OK, physical therapist.  You made your point.

When I first worked with you in early 2013, about six months after cancer radiation therapy zapped the nerve bundle for my right arm (the brachial plexus), you gave me wonderful exercises to strengthen my rotator cuff muscles.  At the end my scheduled visits, you said I would have to keep doing those arm exercises daily for the rest of my life, and I shouldn’t lift more than 20 pounds with that arm, ever.

After months of daily exercises, those muscles grew strong.  I REALLY wanted to think my arm was normal again.  I thought I could be done with physical therapy and go back to lifting everyday things like kitty litter and groceries and storage boxes in the closet.

NOW, a year after our last visit, I get it.  Now, when I can’t raise my arm over my head without shoulder owies.  Now, when two sequential PET-CT scans show degeneration in the right shoulder joint. Now I’ll go back to daily arm exercises with the wimpiest exercise bands and no hand weights, like a newbie.

At least I kept the printouts of all the exercises so I know what to do.  I may take a while to get the point, but I CAN learn.

Maybe on my next flight to Denver for my clinical trial, I’ll be able to raise my right arm comfortably again.  If so, I’ll raise my arm …  and ask the flight attendant to help me by lifting my bag into the overhead bin.

Cancer reality: 20-something
Me: 1 (extra credit for keeping the exercise printouts)


Coping with Side Effects

I have a 20-pound lifting limitation on my right arm from radiation damage. My right brachial plexus — the nerve bundle that controls the right arm — took a full dose hit last summer.

I take an engineering approach to such limitations. I find myself looking at boxes I need to move and thinking, “If I take out these books, then the box is only 40 pounds, and if I divide that by two arms …”

I do not tell my radiation oncologist about these moments.

I hope he’s not reading my blog today.

How Much Do CT Scans Increase the Risk of Cancer?

This is the title of a great article published today by Scientific American about risks of developing future cancers from CT scans. Since cancer patients get frequent CT scans, this subject comes up frequently among lung cancer survivors. I learned some key facts:

(1) Estimates of cancer risk have until recently been based on “cancer rates among the long-term survivors of the atomic bomb blasts in World War II,” a data set that doesn’t really mesh with the radiation exposure generated by CT scans. About a dozen studies worldwide are now looking at cancer rates in patients who’ve had CT scans.

(2) The amount of radiation exposure generated by a CT scan is not regulated by the FDA in the US. Some centers use higher levels of radiation than others. Last year the American Association of Physicists in Medicine published standards for CT procedures and doses. Also, as of 2012, facilities that accept Medicare Part B must be accredited by the American College of Radiology and follow their dosage guidelines if they want to get reimbursed.

(3) Radiologists Sarabjeet Singh and Mannudeep Kalra “discovered that they can diagnose certain abnormal growths in the lungs and perform routine chest exams with about 75 percent less radiation than usual.” Massachusetts General Hospital has adopted this approach, and the researchers are sharing their methods around the globe.

From now on, I’m going to be sure any facility that scans me has American College of Radiology accreditation, and I’ll ask if they’re aware of Singh and Kalra’s work.