[Lani]

placing an intramedullary rod down a femur if I understand you correctly is a
rather bloodless surgery. It is done with a small incision and the guidance of the rod is done by watching images on a portable fluoroscopy (xray machine) so actual cutting of tissues is minimal.

If you misunderstood and the surgery they plan is more extensive, say for a subtrochanteric metastasis, it is possible they might have to do more dissection if I understand the situation correctly.

Either way, you would not qualify for nor receive TM1 before having your surgery, but you could apply for it and if you only needed the intramedullary rodding and your incision was healed one or two weeks thereafter, it probably wouldn't matter than whether your platelets were decreased or not.

So the question is whether your insurance would pay for herceptin+lapatinib--and whether the orthopaedic surgeon would want you on Zometa. Bone healing and remodelling are a balance between the work of osteoblasts (bone forming cells) and osteoclasts(bone destroying cells). I would ask the orthopaedic surgeon if Zometa alters the balance in a way that is or is not be beneficial to bone healing right after surgery.

It certainly helps fight the effect breast cancer mets normally have on bone, it is only a question of the timing.

Just food for thought