A friend wrote that vegetables get radiation treatment to make "them look better and keep longer". Having just received another dose on my right arm, I hope the same applies to me! I've had four specialist appointments and a radiation treatment in a period of seven days.

My first appointment was with my local radiation oncologist. After hearing of increased pain and MIBG activity in my right arm he ordered a single (larger) dose of external beam radiation. Since then I've felt pretty exhausted. The first night was worse but my energy has been reduced for a few days now and the pain in my arm has increased! This is expected behaviour that will lead, hopefully, to reduced pain and increased mobility in the near future.

A check-in with my medical oncologist generated a couple of new bits of information. A small abdominal tumour was evident, but not noticed, on my CT scan from four years ago and my Chromogranin A count has gone from 520 (ng/ml?) to 620 in the past 3 months, though the latter is not statistically significant. Chromogranins (more on these later) are types of proteins found throughout the neuroendocrine system and in neurons in the nervous systems. They are used as an indicator of pheo activity because they provide a simpler cheaper test than the alternatives of measuring catecholamines directly. However, measurements apparently may vary with meal consumption so patients are often required to fast before a CgA test - this didn't happen with me.

The neurosurgeon who has seen my MRI and CT scans since he last saw me seemed satisfied with my condition and said he'd operate only if neck pain were to increase, a tumour were to threaten neurological interference or if some sort of structural collapse occurred. I also learned that there's generally increased pain before the latter. I'm going to now look for a physiotherapist who can help me build the strength in my neck to avoid further problems. While the word is not normally seen in a positive light, he reports some sclerosis around the bodies of my problem neck vertebrae - which is apparently a good thing.