Three Pavement Dives as a Patient With Cancer Makes a Trend

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Adventures in walking for a cancer patient with neuropathy.

Yesterday morning I repeated the pavement diving stunt I pulled in Chicago last May that broke my left shoulder: I caught my toe, staggered a few steps, and played Superman on the hard deck. My official "klutz" merit badge is due to arrive any day now.

This time I had the foresight to fall just as I entered the University of Colorado Cancer Center for my monthly labs. The staffers at the information desk rated it a five out of ten for style, and a flurry of doctors and nurses descended immediately. The nurse who drew my labs insisted on walking me to the emergency room for a quick x-ray, which showed I had not reinjured my left shoulder (whew!). I was discharged from the ER just in time to drive to the airport for my flight home. I still have full range of motion in both arms, but movement is a bit less comfortable. Since I still can't take anti-inflammatory drugs like NSAIDs due to blood thinners, I might choose to get that second cortisone shot I've been avoiding, unless icing can adequately soothe my angry tendons (good name for a rock band, isn't it?).

My legs have seemed weaker recently. I've been traveling a lot lately, and therefore walking and climbing stairs more than usual, which might be at least partly responsible. Also, my feet are getting more vocal in recent months about their objections to past chemotherapy. A paper published in January found that peripheral neuropathy greatly increases the risk of falls among cancer survivors. To which I reply, "ya think?"

This is my third fall in nine months, which set off alarms for my docs at my check-in today. They say three falls in a year counts as a "trend." I've been referred to physical therapy for an evaluation of leg muscle strength, range of motion, and other possible mechanical reasons for my falls. If this doesn't reveal anything useful, my next stop is a neurologist. I had another clear brain MRI in January, so brain mets are unlikely.

A potential neurological issue seems relatively trivial compared to my metastatic cancer, but it does mean more medical appointments when I'd rather be writing. When will I learn to be a boring vanilla cancer patient?

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For patients with cancer, the ongoing chemotherapy shortage may cause some anxiety as they wonder how they will receive their drugs. However, measuring drugs “down to the minutiae of the milligrams” helped patients receive the drugs they needed, said Alison Tray. Tray is an advanced oncology certified nurse practitioner and current vice president of ambulatory operations at Rutgers Cancer Institute in New Jersey.  If patients are concerned about getting their cancer drugs, Tray noted that having “an open conversation” between patients and providers is key.  “As a provider and a nurse myself, having that conversation, that reassurance and sharing the information is a two-way conversation,” she said. “So just knowing that we're taking care of you, we're going to make sure that you receive the care that you need is the key takeaway.” In June 2023, many patients were unable to receive certain chemotherapy drugs, such as carboplatin and cisplatin because of an ongoing shortage. By October 2023, experts saw an improvement, although the “ongoing crisis” remained.  READ MORE: Patients With Lung Cancer Face Unmet Needs During Drug Shortages “We’re really proud of the work that we could do and achieve that through a critical drug shortage,” Tray said. “None of our patients missed a dose of chemotherapy and we were able to provide that for them.” Tray sat down with CURE® during the 49th Annual Oncology Nursing Society Annual Congress to discuss the ongoing chemo shortage and how patients and care teams approached these challenges. Transcript: Particularly at Hartford HealthCare, when we established this infrastructure, our goal was to make sure that every patient would get the treatment that they need and require, utilizing the data that we have from ASCO guidelines to ensure that we're getting the optimal high-quality standard of care in a timely fashion that we didn't have to delay therapies. So, we were able to do that by going down to the minutiae of the milligrams on hand, particularly when we had a lot of critical drug shortages. So it was really creating that process to really ensure that every patient would get the treatment that they needed. For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.
Yuliya P.L Linhares, MD, an expert on CLL
Yuliya P.L Linhares, MD, and Josie Montegaard, MSN, AGPCNP-BC, experts on CLL