Okay, who stepped on a crack...?

After almost a week in the hospital and many, many tests, Mother learned nothing about what caused the pain that put her in it. The day she was discharged, I got her in to see a pain and spine specialist recommended by Dr. Benjamin (her local oncologist), and he almost immediately figured out what was wrong. Based on her symptoms, he suspected she must have a compression fracture in the thoracic spine, and a quick X-ray confirmed that she had, in fact, two fractured vertebrae. Instead of the normal rectangular cross-section, these are compressed at the front to form trapezoids. It's no wonder she has a curved back and excruciating pain. This even causes the pain in her abdomen just under her lower ribs.

This kind of fracture is most common in osteoporosis, but it can also result from metastatic cancer. Mother's cancer marker CA-125, according to Dr. Benjamin, is only 16.4, which is within the normal range and only slightly elevated from eight months ago. He has referred her to a specialist to get a bone density scan to see if she does have osteoporosis, and in the meantime has recommended she take calcium and vitamin D.

The pain specialist gave her a prescription for Duragesic patches, although I suspect she is going to need a stronger dose. He started her out low, and even with the maximum number of Norco pain pills (Norco is like Vicodin but with less acetaminophen so she doesn't strain her liver), she still suffers. Dr. Benjamin pointed out she can use a second pain patch, but when I offered her one last night, she declined. I think she was concerned about the possible side effects, including extreme sleepiness and forgetting to breathe.

Daddy has been talking about putting her in a corset for some time now, and it may come to that. She's already had the bed rest and therapy she should have had anyway, so a back brace, calcium and vitamin D may be all that are left that she can do. Because of her cancer, the hormone treatment for osteoporosis is probably not available to her, and I can't see her going for anything invasive.

Interestingly, it is possible Dr. Benjamin is very distantly related to us. Our forebear Woolf Isaacs married Ellen Benjamin in the Great Synagogue of London way back in the early years of the nineteenth century. Dr. Benjamin's family also hails from London of about that time.