lasting back pain–avoid misdiagnosis

When my back pain started in May 2008, I worried that it could be my breast cancer having come back. I stated so when I saw my doctor. She said not to worry, it was just osteoporosis from when I had chemo before and arthritis, which is typical for someone my “age.” In June I was in agony and had to keep lying down to get through the day.

The pain seemed to ease a bit so that I could walk, not pain free but at a level that I could tolerate. People would make comments about my having back problems, and it kept reminding me that I never had had back problems. My back has always been strong, even in its weaker state since I went through my breast cancer treatment the first time in 2004-05.

Then, the pain accelerated in the fall, around October, increasing so much that by Thanksgiving I was in agony all the time. I could barely sleep, and I was taking ibuprofen nonstop. The pain was increasing and the pills were less effective. In December the pain increased severely. I was in tears most of the time, could barely sleep or move without agony. When I went to the doctor, she said, don’t worry, it’s just your osteoporosis. She sent me for physical therapy, which, of course, I could not do, and for an appointment with the pain experts. I kept saying, Don’t you want to find out what is causing this? I’m really nervous about my history of breast cancer. I knew that breast cancer metastasizes to the bone. Still, everyone said, no, it’s just osteoporosis and arthritis. I went to the emergency room, and they gave me two shots of dilotid plus two vicodin by mouth, and it just took the edge off the pain.

In January when my husband took me to the clinic, at his insistence the doctor I saw that day (my regular PCP was not in) ordered an MRI for 1/23/09, over two weeks in the future. I also had to quit going to the office, something that nearly killed me in itself since I rarely miss work. I can’t even remember now the level of the pain at that point. By then I was taking Tramadol as much as I could and started taking Vicodin, again, as much as I could. I was afraid of overdosing because the effect of the pain killers would fade about an hour before it was time for me to take the next dose. Sometimes I would take the next dose early because the pain was so severe.

Finally, I had the MRI. The next Tuesday and Wednesday I was in such pain that my husband called the clinic and demanded that someone see me. Wednesday afternoon he took me to the clinic, and another PCP saw me. The resident who saw me asked if I’d received my MRI results, and we both saw the look in his eyes when I said no–with an eagerness to hear that the MRI was clear and confirmed that it was only my osteoporosis. He said, I’m sorry to have to tell you that your breast cancer has metastasized to your spine. All I could say was I can’t believe this is happening. After all those months of my saying, Are you sure it’s not my breast cancer . . .

I don’t know how I could have let myself go that long without contacting my oncologist directly and teling her what was going on. I believed that my PCP was talking to my oncologist, though, because she was thorough about everything else. I can’t go back in time nor do I want to dwell on what happened because I need to concentrate on fighting this disease. My advice to anyone else who has a history of cancer and then has suspicious symptoms that you go to your oncologist directly with your concerns. If you have a good oncologist, s/he will find answers.

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