Saturday, June 19, 2010

Chronic - a word I dislike as much as cancer

The CDC has a whole set of programs to define chronic diseases. Wikipedia defines chronic disease as:

'In medicine, a chronic disease is a disease that is long-lasting or recurrent. The term chronic describes the course of the disease, or its rate of onset and development. A chronic course is distinguished from a recurrent course; recurrent diseases relapse repeatedly, with periods of remission in between. As an adjective, chronic can refer to a persistent and lasting medical condition. Chronicity is usually applied to a condition that lasts more than three months. The opposite of chronic is acute.

The definition of a disease or causative condition may depend on the disease being chronic, and the term chronic will often, but not always appear in the description:

* Chronic fatigue syndrome
* Chronic osteoarticular diseases: rheumatoid arthritis, osteoarthritis
* Chronic respiratory diseases: chronic obstructive pulmonary disease, asthma
* Chronic renal failure
* Diabetes mellitus
* Chronic hepatitis
* Autoimmune diseases, like ulcerative colitis, lupus erythematosus
* Cardiovascular diseases: heart failure, ischemic cardiopathy, cerebrovascular disease
* Neoplasic diseases not amenable to be cured
* Osteoporosis
* Cancer
* Chronic GHVD: intra-oral

Many chronic diseases require chronic care management for effective long-term treatment.'

I was told during cancer treatment that cancer is no longer treated as a terminal disease but as a chronic disease. At that point, I thought that was the better of the two options. I dislike the word chronic when it is associated with multiple conditions affecting my body (and life). I would prefer the word 'acute' which is defined as medical conditions which occur and go away (are healed). Terminal is not an acceptable word either.

Yesterday at the back doctor, I asked him what was the big picture and long term prognosis was with my back. He said that as we get older our joints get older and worse. My back problems start with my degenerating disks and I have all sorts of areas of inflamed nerves and pain areas. As we do each treatment, we find different areas of pain surface or previously treated areas resurface.

He did say I am doing all the right things - I take my medications, I do my exercises, I go for a daily walk, I have a memory foam mattress topper, I switched to a smaller purse, I don't carry things, and I keep coming back when in pain. There aren't many more switches I can make in my life that will help.

Basically, the doctor said its a chronic condition that is with me for life. However as we go through life our bodies change and there is a small chance that my body will change and the pain areas will abate. The goal is to offer me treatments that last a year or more for each area of pain so we will continue the injections of different sorts in different areas until my body morphs into a pin cushion, or we run out of painful areas (not likely), or I drop dead (what a pleasant thought). At least my back doctor is a nice guy with a sense of humor about this.

The next steps in my back saga are I was given a cortisone injection in my left hip and I will have a radiofrequency denervation (the nasty procedure where they kill nerves) in my right sacroiliac joint in a few weeks. I have already had two cortisone injections in it but it is still causing pain that is wrapping around into my right hip. The cortisone in my left hip is already working. Three years ago just before my breast cancer diagnosis I was told I had bursitis in my hip and no treatment was offered because of the pesky cancer thing that was deemed as more urgent.

I felt relatively good about my appointment yesterday but I ended up being there for more than two hours because of the injection and scheduling and preop for my next procedure which made me late for meeting a friend for a walk. Then my husband got home before we got back from our walk and we rushed off to the beach. It was absolutely beautiful - not a cloud in the sky, a light breeze, and the crowds were leaving so we had lots of space. This was followed by a dinner of steamed clams - yummy! It ended up as a very nice but full day. Just that icky word 'chronic'.

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