update on Jim

Just as well I didn't contact everyone sooner because the prayer requests have changed day by day for the past week. As you know Jim had chemo last Thursday. He also had an appointment with his oncologist at West Clinic the same day. Jim was concerned about a new development--a swelling and pain in his neck actually under the jaw. He has suffered with mouth sores since early summer resulting from one or another of the chemo drugs, but this was different. The Dr. told him that it was not a lymph node, which relieved us somewhat because that is always a fear. However the pain continued.

The chemo side-effects were as bad or maybe the worst yet. Certainly the duration was longer. He was in bed from Friday until Tuesday morning. On Tuesday, we made an appointment with our internist to see about the pain in the jaw area. Dr. Castellaw was quite concerned because the bone in the mouth was visible in 2 places. He then sent us to an ENT to determine whether this should be biopsied. In other words, he wanted to be sure it wasn't a metastasis or a new primary cancer.

The ENT said no biopsy necessary, once again relieving our minds, but not much help with the pain. She said the lump in the neck was a salivary gland, gave him a decadron shot which temporarily helped with inflammation, and made the pain more tolerable.

As the shot wore off the pain increased. Today he made an appointment with our trusted prosthodontist who recognized the severity of the problem and sent him immediately to the oral surgeon. By this time Jim was frustrated, frightened and in excruciating pain.

The oral surgeon confirmed that this is osteonecrosis (dead bone essentially) resulting from the Zometa Jim has taken monthly to treat the bone metastasis of the lung cancer. Osteonecrosis is very difficult to treat and there are several options but for us right now the most important consideration is treating the infection which is causing the pain.

Pray for:
1. relief from the pain (he is taking oxycodone).
2. healing from the infection (Augmentin)
3. that he will be able to eat soon
4. that he won't have to be under the care of an infectious disease specialist, hospitalized for IV antibiotics


We are grateful that the x-rays show the damage to in both areas of the jaw is less than expected, although if I understand it correctly, the Zometa has a long half-life ( stays in the system for years), continuing to do its good work and its bad. We are also thankful that his teeth aren't loose yet.

This is a very serious infection, doubly hard to treat because of the other chemotherapy drugs he is taking and his resulting compromised immune system. We will address the other problems later.

Under His wing,

cyndi