Ask A Survivor: Physical Therapy

Patrick Koske-McBride
5 min readSep 6, 2023

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Q: What do you do when you feel like it’s hopeless?
A:
Sweet Jebus, dude, that’s dark. How are you doing?

Q: Isn’t that the point of these borderline-narcissistic health updates of yours? To assure the public that you’re still alive?
A:
Well, yes and no.

Q: Cancer survival seems like a fairly binary situation: either you’re dying of cancer, or you’re healthy.
A:
There’s significantly more nuance than that, but the point of these essays is to prepare everyone out there not only for the challenges of life-limiting cancer, but for the much larger, more-difficult challenges that lie after that. And that’s not a simple “Alive/Dead” qualification.

Q: What does that have to do with your bizarre, six month leave of absence from this column?
A:
I shattered my leg in February, underwent orthopedic surgery, and spent several months on bed-rest.

Q: That’s a decent excuse, but what does all of this have to do with cancer?
A:
Do you know what neuropathy is?

Q: Isn’t that just numbness?
A:
Yes, but it’s a VERY common side effect of chemotherapy, especially the sort of long-term, multi-year chemo my blood cancer buddies and I go through.

Q: What does that have to do with your leg?
A:
Ever tried going up stairs, in a hurry, when you can’t feel your foot? It does not end well.

Q: So, the ultimate point of this essay is that long-term effects and health issues surrounding cancer are subtle, hard-to-discern, and likely-fatal, if unattended?
A:
That is the most-broad, general gist of this piece, yes. If you, or a loved one, suffers from “Drop Foot” or any other abnormal reflexes, get on that problem now, today, before that problems becomes a full-blown crisis.

Q: That seems like a fairly simple point for six months’-worth of unexpected research.
A:
That is the critical central point, but I learned a helluva lot along the way.

Q: Great: Any other insights you’d care to share?
A:
Even in the Biomedical Industrial Complex, Planet Cancer is its own, unique habitat, and it’s quite possible to go to the very best cancer center on the planet, and wind up with Dr. Christopher Duntsch if you have to go to the ER after a concussion.

Q: Ah, not happy with your orthopedic team, huh?
A:
The doctor-patient relationship is a critical one, and, because my last GP was removed from my poor-person insurance (probably for her diet of live kittens), I’ve had to rely exclusively on the faculty of my cancer center, so, if it can’t be fixed by an oncologist, neurologist, psychiatrist, or oncologist, I’ve been playing ER Roullette with my non-cancerous maladies. And, whilst I make it a point to consistently go to top-ten rated medical facilities for my cancer-related care; it’s impossible to vet a medical team after a physician says, “I don’t know what that is, but you should go to the Emergency Department,” your ability to vet your medical team goes out the window.

Q: So, you broke your leg, and decided to see a brain tumor specialist?
A:
I broke my leg the day before my regularly-scheduled appointment (I get my scans almost a week in advance, these days), and decided to give him first crack at it. There is an ER in that hospital, after all.

Q: You’ve evaded two questions in a row: What’s up with your orthopedic care?
A:
I get my neurosurgeries done at the second or third-best neurosurgical facility in the US; I get my post-surgical/ongoing care at the seventh rated facility in the US for post-surgical cance care. I did not notice a significant difference between the two. The ortho ward in that hospital system, on the other hand, is in the Top 40. I noticed a definite difference in the quality between the ortho ward and my other providers.

Q: But your leg was repaired, right?
A:
Yes, but literally only after sitting in a hospital for two nights in a cast and neck collar, and after I mentioned “malpractice” when the hospital switched surgeons on me without advanced warning (AUTHOR’S NOTE: I have no doubt that my hospital has some sort of blanket liability that allows them to swap doctors on me without consent, but my bioethics professor told the class, a hundred years ago, that it is absolutely beyond illegal for surgeons to sub in other principle surgeons without the patient’s express permission, so, that kind of goosed my adrenals). Certainly, in the contex of my (experimental) cancer care, that sort of last-minute, for-the-hospital’s-convenience tactic would not fly.

Q: Still evading the question.
A:
My leg is currently healing, and I’m expected to make a full recovery before the end of next year. I’m currently in physical therapy for both my most recent boo-boo and to repair any other reflexes damaged by chemo. Which is working, but it’s slow and miserable.

Q: Any other health updates?
A:
So, as of June-ish; I’m still NED, but I have early-stage gingivitis.

Q: Who cares about oral health?
A:
Dentists, I believe. Also people who enjoy chewing or proper pronunciation. But, more importantly, every long-term survivor I know has some sort of ongoing dental/oral health issues. I’m bringing this up because at one of my earliest cancer support groups; I overheard two of my breasties talking about dental issues, and; because I am a moron, I assumed that wouldn’t be applicable to me. I don’t want your general health issues to catch up with you in a moment of “It couldn’t happen to me.”

Q: And, all of this contributes to your lapse in productivity, because…?
A:
Between physical therapy, ongoing cancer care, and ongoing dental intervention; I’m back at my chemoradiation level of 4–6 hours a day spent just maintaining my health at “Near failing.” It’s exhausting. If you have to spend that amount of time locked in the grim realities of your own health, you’re rarely at your best, let alone well-rested.

Q: Bring it back to the general audience…
A:
When you get a cancer diagnosis; that becomes your biggest, most-dangerous issue. When that fades to, “It’s manageable,” a whole host of new-ish health issues might leap at you, and you want to manage them as aggressively and meticulously as you did your cancer. Which is a full-time job, unto itself.

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Patrick Koske-McBride
Patrick Koske-McBride

Written by Patrick Koske-McBride

Science journalist, cancer survivor, biomedical consultant, the “Wednesday Addams of travel writers.”