Medical Update; My big toe

I’m amazing at how many weird things we’ve discovered about my body since I’m scanned regularly and often. So many things that I would never have known about have been found and then we’ve had to figure out if they mean anything. That process can be fraught with angst since I/we automatically assume that anything weird must be because of the cancer and not because well … I’m just weird.

For this update, we are talking about my big toe. The right big toe.

It all started with my diagnosis of Bisphosphonate Induced Osteonecrosis of the Jaw, which you can read about in my earlier blog here. Once I knew that my body is sensitive to this sort of side effect, I addressed it with all of my complimentary doctors. I do love having different doctors looking at my body from different perspectives! In the functional medicine world, osteonecrosis is called other things, but in their understanding there are other parts of the body that are affected, not just the jaw, specifically the small bones of the feet and the femurs. Since my femurs already have titanium rods ensuring their stability, that’s leaves the feet.

So off I went for x-rays of my feet. My right big toe turned out to have some strange bony growth and an MRI was recommended. Off I went for an MRI.

Turns out, that weird bony growth is a “bony island.” That’s pretty simple, just a part of the bone that decided to grow strangely and make a little ball rather than lie flat. What the MRI also revealed was that my bone marrow was oddly reactive, basically that it’s more active than expected.

The radiologist posited two options to explain that unexpected reactivity: 1) metastasis in the bone marrow itself; or 2) red marrow conversion.

As with any result, I immediately began to research these options. The first was not something I wanted at all and I was relieved pretty quickly to find out that I had no other indications that my bone marrow has metastasis — if that had been the case, my regular bloodwork would have looked wonky and my bloodwork has been reassuringly in the normal ranges for a quite a while, absent a few dips in my potassium. The second topic sent me down a rabbit hole learning about red blood marrow versus yellow blood marrow and why it is very odd for someone of my age to have red blood marrow in my big toe.

Turns out all of my doctors agreed that the second option (red marrow conversion) is what is showing up on the MRI. My podiatrist put it this way: “Your blood marrow is trying to save your life.” I like that. Basically every “long bone” in my body has revved up the red blood cell making areas to help support my body as it deals with all the toxicity from the medication I’m taking. Yes, the big toe has the longest bone in the foot, just not so long when compared with the femur or humorous.

Absent doing x-rays and MRIs, I’d never have known about the bony island or the red marrow conversion going on! Now, I’ll get a full body PET/CT so that we can monitor my feet. That’s another thing I learned — those PET/CT scans, they only go from the head to mid-thigh. Without those extra tests of my feet, we might not ever have scanned my body fully with the PET/CT.

While I do enjoy learning about all of this, I must say that I do still wish for simple tests that just come back “normal.” I didn’t appreciate all of the “normal” tests I used to get before cancer. I’ve had enough of these out of left field, odd things that I would never have known but for cancer.

And that’s the update!