[willjames2Participant]

Hi guys,

Just wondered if anyone knew how long fractured vertebrae may take to heal and whether anyone has had similar problems? I believe I have a fracture of L2 & L4.

I still get occasional spasm/tightening however nowhere near as bad as before. I'm taking morpheine sulphate 30mg slow release (twice per day) and paracetamol throughout the day. I can also take Diazepam up to 3 times per day however it knocks me out and makes me tired so I'm trying to avoid taking the diazepam.

I'm struggling getting around the house for the fear of moving/twisting and it going into spasm however I'm also trying to keep a little mobile so as not to seize up.

I'm sleeping in an adjustable bed (I was really lucky my mate lent me one his mum bought and used for a while) and so sleep slightly upright which I find the most comfortable.

The Doctor said that he may refer me for some radiotherapy on my back (to help speed the healing process) however this depends on what the Radiologist thinks.

Any advice would be most welcome.

Thanks in advance.

Scott;-)

[janwParticipant]

Hi Scott

Prior to the collapse of my three vertebrae, I suffered about a month of severe pain in my ribs and back, together with the very painful spasms which you have experienced. In order to avoid putting further pressure on your bones, my consultant advised me to avoid lifting any items of more than a couple of pounds in weight

My vertebrae collapsed six weeks prior to my diagnosis resulting in a height loss of around 3". Following the collapse, I spent a good 10 days in bed hardly able to move and then used a walking stick to help with mobility throughout the four cycles of CDT and a wheelchair during stem cell transplant. You are fortunate to have an adjustable bed because it is painful to try to lie flat and when getting up out of bed then straightening your body. My most comfortable sitting position used to be propped up with four pillows in bed, because hard chairs were too uncomfortable and getting out of low soft chairs was painful. We had to change our soft settee and throw out our dining table/chairs because I couldn't use them with the pain.

I have a curve in the top of my back and my ribs are a lot wider below my chest where the bones have collapsed together. For the constant pain in my back and ribs, my consultant prescribed Fentanyl 50 mcg slow release pain patches which each last for three days, together with up to eight tablets of Tramadol 50 mg which have helped considerably with the pain. I started on the recommended monthly bone enhancing drug Zometa after my stem cell transplant and this has also helped to gradually reduce the bone pain. I still find sitting down on hard chairs uncomfortable and my back aches if I stand for too long.

It took many months after the stem cell transplant, before I was able to walk without the walking stick and my mobility was quite limited due to the constant back and bone pain. It's taken me just over two years before I can comfortably lie on either side in bed, but I miss being able to sleep face down.

Prior to my CDT, my consultant mentioned after my SCT if I still suffered from back pain, I might consider kyphoplasty where a balloon is inserted into the fractured bone through a hollow needle to create a cavity or space and a cement mixture is injected into the space once the balloon is removed. Several other members on the forum have successfully had this treatment with good results. (You can search their posts under the heading of kyphoplasty or vertebroplasty.) I know this procedure is used for compression fractures, but you would need to discuss this process for your fractures with your consultant to see whether it might be of benefit for you.

Regards Jan

[willjames2Participant]

Hi Jan,

Thanks for info. It seems like you have had it much worse than me… and here I am feeling sorry for myself! I too have lost height. I used to be 5 ft 11" however when I was measured recently at the clinic I was only 5 ft 9" resulting in the loss of a couple of inches, this surprised me.

When I said I believe that I had fracture of L2 & L4 I'm not exactly sure because no one has really explained. The very first Doctor I met at Tameside mentioned this but also mentioned that the Sacrum may also be fractured. He got this info from the images the Clinic at Menorca provided (however the clinic admitted themselves that their equipment wasn't the most up to date so the images weren't fantastic). i also think this Is because its a secondary thing to to the Myeloma and they seemed to think it will heal itself with time. I think I need to discuss in further detail with the Doctor when I return to the clinic. I too am scheduled for Zometa again on the 20th September.

Funnily enough I have a reasonable day today however I've just started taking the Dexamethasone again so I'm wondering if that helps with the pain? The Doctor said it may do. I have also decided to take the diazepam and if I'm a bit sleepy then I'll have to put up with it.

Just out of interest have you been prescribed Calcium Tablets? The Doctor said that he may put me on them when I return and I wondered if that would help.

Hope you are feeling better.

Regards

Scott:-)

[eveParticipant]

Hi Scott

Well Slims story is very like Jans except time wise but everyone is individual .
Ask for a copy of your MRI report that will tell you how much damage.

Slim lost 4. 1/2 inches in height,but has now gained an inch.he has been on Ad-cal plus Zometa for over 2 1/2 years,I do not think he will come off either as Slim has only had 6 months remission.
He was told the same as Jan no lifting,finds hard chairs difficult ,he uses a special cushion between his legs,helps bone pain.

Slim still has OxyContin 30m night and day,when he is bad paracetamol with OxyContin ,as it enhances it.He has just started on Tomazipan,only to sleep,but Slim says it does not work hence e mail aw 5am.
All this medication is addictive,and only you can judge your need,I know the damage that Slim has to all his bones,plus I know Slim has a high pain threshold,so in the grand scheme of things,I take the attitude,quality of life is more important,than addiction .

You have to control your own drugs,if you feel you want to cut down do it slowly,go from 30 to25m.excises is very important at this stage little and often,walking,because muscle supports the bones,and large doses of steroids destroy muscle,but fight cancer.Slim is in a wheelchair,but everyday,he walks as far as he can twice a day,plus potters about on sticks,so important to keep as active as you can,. Eve

[janwParticipant]

Hi Scott

I would ask your consultant for some more information about your fractures, especially with your height loss of 2". As Eve has suggested, try to obtain a copy of your MRI report which will show the extent of the bone disease including fractures and lesions. Apparently, I have quite a few lesions in my skull, thigh and tops of arms. You are right, steroids can help decrease inflammation and pain. If you find you cannot manage your pain, then you can ask to be referred to a pain specialist. Yes, I've been prescribed Ad Cal (calcium and Vitamin D)by my GP for the past two years. However, my consultant doesn't appear to be bothered whether I take this supplement.

According to Myeloma UK some 60 – 70% of patients have evidence of bone disease at diagnosis. At least there are now bisphosphonate drugs (e.g. zometa) available to help stop the breakdown of bone, reduce bone pain and stop further bone fractions. I feel very fortunate that my bone destruction did not result in complete lack of mobility and following treatment most of my pain can be controlled by pain medication, avoiding lifting and learning to rest when the pain increases with activity.

Regards

Jan

[willjames2Participant]

Jan and Eve,

I'll discuss with the Doctor on my next visit. I have actually had a good couple of days however as I said I'm on the Dex so I think this is helping and decided to take the morpheine sulphate, diazeapam and paracetamol as required throughout the day. The only fear is when I stop the Dex again after this four day period within the cycle then I'll deteriorate again and the pain will come back hence the reason I'm taking all the painkillers I have been prescribed instead of struggling on without taking them all and hoping I can manage. No good in trying to be a hero when in pain!

Eve's comment is interesting though with regards to the Steriods how they can destroy muscle but fight cancer. I have been trying to get up out of my chair about once an hour and have a slow walk around the house to exercise a little and hopefully this will help going forward.

As Eve said the drugs are addictive however I'm not too concerned about this at the moment (although I have only been on them a short time) I don't have an addictive personality and although I recognise I'll need to probably reduce the dosage slowly however I don't think I'll have an issue coming off them as soon as my back feels strong enough to manage without.

When I visited the clinic last time the Doctor said that from the results of the 'skeletal survey' they had done they had only found a couple of tiny holes within my skull and apart from my lower back where I had some lytic lesions I was pretty much clear every where else at the moment which I found to be quite encouraged with. Although the holes in the skull worries me the Doctor seemed quite relaxed and said that he expected to see them in the skull and that they would heal. I'm sure the Zometa will help with this going forward which I'm having again come Friday this week.

Thanks for the useful info again guys, it's much appreciated.

Regards

Scott;-)

[eveParticipant]

Hi Scott

If you go into the Mac Milan steroid site it tells you all about the side effects!!!again everyone is different,Slim has lost around 3 stone,steroids never put weight on him,but some people gain weight!!!
Long term effects of steroids can cause extra problems,but I think for some one like you who are on first round chemo,it should not be a problem.

The lesion damage you mention,is small,I know it's frightening when they say lesions on Skull,they are able to see them because its a flat area,Slim has them there as well.
The spine ribs and shoulder blades are different ,MRI for spine and area around,the concern there is compression of the spinal cord,big one.Forgot to say Slim has no compression,the reason he cannot walk very much is complications as other complaints come along,Slim had a blocked artery,which they cleared,but old hip replacement became very painful,so waiting to find out what it is,but like all Myeloma people has good days and bad.
What you describe is normal,,Zometa can give you flu like symptoms again normal,over a period of 2 3/4 years Slim has been on Zormeta it's normally 2 years,different conconsultants have different ideas I do think Slims bones would be a worse state,if he was not on Zometa,you can help yourself with gentle excises ,the fitter you become the more it helps.

You do deteriorate coming off Dex,but as the months go by you will see improvement,all takes time,small steps,you are on this roller coaster for a life time,as an observer ,I think the Chemo reachers a height about the 3 or4 cycle,and then you start to see a slow improvement,little steps. Eve

[willjames2Participant]

Hi Guys,

Just a quick update on my back pain. It's much better and I'm much more more mobile now however still no where near perfect! I even managed to walk into Christies yesterday (I have used a wheelchair up to this point) for any long walks around the hospital so that's an achievement in itself!

I went to see the Radiologist to see if Radiotherapy may help treat certain areas and speed up the healing process. He looked at the scans and said that I had problems throughout the spine however there was no specific place that would benefit greatly or need it which wouldn't involve destroying some healthy bone marrow at the same time so it's best to leave it as is.

He also seems to think that the treatment must be working because the pain is reducing and the mobility is coming back. Fingers crossed eh!

All in all I was quite pleased that I didn't require any further treatment and glad to be showing signs of improvement.

Speak soon.

Scott 🙂

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