Dayton Doctor appointment scheduled

Todd didn't go into have his CBC blood work done today.  His local oncologist wants to see him, so he is going to do both tomorrow, Tuesday, January 6, 2015.  We are supposed to get a fair amount of snow tomorrow, so I'm hoping it won't hinder us getting to the appointments.  We aren't sure if he is needing transfusions or not. 

His frozen shoulder has been given him a lot of pain the last few days.  He has very limited mobility with it, making it hard to dress, drive, or even open a car door.  He's tried heat and a little message, but we have to be careful because his platelets are so low (bruising or bleeding concerns).  He is trying to do some of the exercises he learned from the physical therapist when this first happened.  We were thinking back to when this first occurred and it was at a time when he was getting platelet and blood transfusions.  So, we aren't sure if there is a connection between the frozen shoulder flare-up and the transfusions or maybe even the very low blood counts. 

I will have another update after we meet with the appointments tomorrow. 

Day +42: Frozen Shoulder update

Todd has his appointment with a Orthopedic doctor at the Cleveland Clinic on October 27, 2014.  He reviewed Todd's MRI results and concluded that there was a tear in the Glenoid Labrum tendon in the rotator cuff and an area of his shoulder joint was dented from a prior dislocation (at age 16 when Todd was sliding into home base!) which is called a Hill-Sachs deformity. He described the injury like the humeral head (pictured above) is like ping pong ball and when the dislocation happened it puts a dent in it.   Todd's is not serious enough for surgery and it is likely he has been living with this with no serious problems since that time.  Neither of these two discoveries are responsible for Todd's frozen shoulder in his opinion.  He is not sure what caused this to happen.  He said it is common in people with diabetes; one day they can wake-up and have a frozen shoulder for no reason. I think it is from the Neupogen.  He said it was possible. 

The frozen shoulder has loosened up considerably on its own with messaging, hot showers, heat, and doing some exercises we found on YouTube.  To get his range of motion back to normal, the doctor recommended physical therapy.  He will have an evaluation done by a physical therapist at a nearby Cleveland Clinic location in Avon Lake on November 11, 2014, who will recommend further treatment at that time.  He will follow-up with the orthopedic doctor on November 24, 2014, at the Main Campus of the Cleveland Clinic.  He also recommended heat and/or ice, whichever works best.

Meanwhile, I can't say enough about these exercises we found on YouTube.  They are the same ones recommended to us by the Orthopedic doctor in a brochure he gave us.  So, if you ever have a frozen shoulder, I highly recommend you check out this video:  
  
http://www.youtube.com/watch?v=TE3AF_NOw4s

But, I'm no doctor! So, as in all medical disclaimers-check with your doctor!


More information:
Hill-Sachs: 
http://orthopedics.about.com/od/instabilitydislocations/qt/Hill-Sachs-Defect.htm

Day +33. One third way through recovery

Last Wednesday's  and Friday's appointments were uneventful which equals great news!  No fluids or transfusions were needed. We were in and out in less than 2 hours.

Blood counts on Friday, October 17, 2014:  Hemoglobin 10.3, white 2,900, ANCs 2,150 and Platelets at 28,000. He still has a way to go until all of these numbers make it into the normal range. Right now, only his ANCs are officially in the normal range; all others still considered low. 

Update on Todd's frozen shoulder:  It has improved with hot showers, messaging, and the heating pad. His range of motion has increased but it is not back to 100%. He has a MRI scheduled on Tuesday, October 21, 2014. 

He developed a light rash on his face and neck on Tuesday, which is a sign of Graft versus Host disease. The nurse coordinator is not concerned about it at all. We were told to treat it with hydrocortisone cream for now and to be sure that Todd wears sunscreen everyday. Sun exposure can bring out GvH of the skin even on cloudy days. So we have added sunscreen to the morning regimen. 

We had visitors from home this weekend.  This was such an encouragement and blessing. Jeff, the associate Pastor of our Church, Hillside Chapel, treated us to lunch on Friday afternoon. It was so nice to talk about everyday things and to have prayer with him. 

Then, our three daughters came up for the weekend. We went to Little Italy for dinner and dessert on Friday night. 

On Saturday, we slept in and I made pancakes and bacon for breakfast. Then we went to the Cleveland Art Museum for the afternoon. It was amazing. We have all been to great museums like the Louvre in Paris and The British Museum in London; We didn't get to see everything, so we definitely would love to go back. We finished the day with dinner at the Cheesecake Factory and the girls had Menchies frozen yogurt for dessert. 

On Sunday, we enjoyed pan chocolat and then drove down to Bay Village to get a look at Lake Erie. After that, we did some eating, walking, and shopping at the Beachwood Mall. It was a great weekend. Being around our daughters was so much fun!

Todd has a treatment and a doctor's appointment tomorrow morning and afternoon. 

Day + 27: Frozen Shoulder side effect

Today Todd saw the bone marrow transplant doctor. Everything has been going well, except for Todd's shoulder pain. Todd has been experiencing terrible shoulder pain since about 4 days before he was discharged from the hospital. At the time, they said he could have been caused by the Neupogen infusions they were giving him, but we kept thinking it was from laying in the bed or sleeping on it wrong.  He even considered deterioration from playing sports.  They treated the pain with oxycodone since he is not allowed to take any anti-inflammatory medication like Ipuphron. We thought it would go away...

But it hasn't. Instead, it has only gotten worse in the last few days. He has very limited mobility of his left arm. He can't raise it up at all and when he tries he is in excruciating pain. So, we brought it up to the doctor again today, and she said it is likely "Frozen Shoulder" and that it was likely caused from the Neupogen. I had never heard of it before so I looked it up online. 

http://www.mayoclinic.org/diseases-conditions/frozen-shoulder/multimedia/frozen-shoulder/img-20007530

It can occur after a serious medical condition. I also looked at the side effects of Neupogen and it said that muscular problems have occurred about 22% of the time in studies and it occurs in the left shoulder (exactly the shoulder and arm that hurts Todd). Todd thought it was his rotator cuff, but we ruled that out too because it was his left arm, not his dominant pitching/throwing 

right arm. 

So, what happens now?  They are setting up appointments for an X-ray, Orthopedist, and physical therapy to confirm the diagnosis and to receive treatment to loosen up the joint and thereby relieve his pain. However, I'm afraid this is going to take weeks or months or possibly longer to resolve. 

We will keep everyone posted. Please pray that he can see a specialist soon and for pain relief. 

More information http://www.drugs.com/sfx/neupogen-side-effects.html