To Bring Everyone up to speed…
October 3, 2016
This all started on Monday, October 3rd, 2016. My mom and dad
had been to a small group meeting a couple nights before where she had been
told by one of their good friends that her “eyes didn’t seem as bright”.
This, I suppose, keyed my dad in to watch her and on the 4th when
she woke up she was jaundiced. Mild yellowing of the eyes and skin.
Dad sent her to her local doctor’s office to get it checked out.
After several tests they determined that she would need a CT scan and tried to
get her in to Prattville Baptist Imaging center to receive one. After
trying and failing to get a precert from her insurance she was sent home and
told they would try again tomorrow.
Dad, in light of mom being sick took off work to go home and see her. He
called me at work and asked my opinion on what to do, to which I responded I
would take her to the ER where precerts don’t matter. Though mom said she
felt fine except for itching all over, they both agreed and she went to Baptist
East ER.
At the ER they decided to do a test called an MRCP, which helps to identify
obstructions in the biliary tract. After waiting a while the radiologist
who read the film, a friend of my mom’s, came in and told her that she had an
obstruction of one of her bile ducts and that the head of her pancreas was
enlarged, and that that was concerning to him. It was deemed that she
needed an additional test called an ERCP, though she would have to be taken to
Birmingham to UAB hospital for that.
After many hours in the ER, they finally got a room at UAB and the ambulance
arrived to take her there at about 1am on the 4th.
October 4, 2016
My wife and I arrived at the hospital early in the morning on the 4th.
Mom was in decent spirits but nervous, as one should be in such a
situation. The day was spent thinking that we would be able to have her
back for her ERCP that day, which ended up not happening. After we
arrived me and dad left the room to “get coffee”. As soon as we exited
the room he handed me a trifold cluster of papers. The radiology report
from east. Long story short, the words “suspicious for malignancy” stuck
out and rang around in my head and everyone else’s all day. This could
NOT be happening.
Around midafternoon mom’s attending doctor and approximately 7 or 8 medical
students came in to talk to my mom. They said that she would be scheduled
for tomorrow (Wednesday the 5th)
for her ERCP to possibly place a stent in her biliary duct to decrease her
jaundice. They also said that she would be scheduled, simultaneously, for
an EUS – Endoscopic Ultrasound. During the EUS she would also have a
small needle biopsy of the mass in her pancreas. According to the doctor,
Histology was in the room for such procedures and as soon as they had aspirated
cells from the mass they would go directly under a microscope and we would know
what the culprit was. Cancer was on their radar, of course, but he said
that there were many other things it could be – just a benign mass, autoimmune
pancreatitis, etc… Knowing that there were other possibilities gave us
some hope.
About this time we had to figure out what to do in regards to Kailey, my
sister. I had made her a promise on the 3rd that I would let
her know if she needed to come home, as she was on a beach vacation with a few
friends over their school’s fall break. I wasn’t so sure that we didn’t
need to call her and tell her that maybe she might want to come home.
After a family discussion we decided it was best to call her together, lay out
all the facts and all we knew, and let her make her own judgment. After
several hours of travel, Kailey arrived in Birmingham and stayed with Sheila
and I in the hotel attatched to UAB hospital.
October 5, 2016
“The procedure is scheduled for 1:30 pm”,
says mom’s nurse about the EUS and ERCP to be done today.
This gave me enough time to get dad downstairs to the cafeteria for some
breakfast. The room that mom had been in had almost no accommodation for
a significant other and he looked like he hadn’t slept or even rested in days,
some breakfast would be good for him. After we got down to the cafeteria,
got our breakfast and sat down to eat dad’s phone rang – it was Kailey.
They were taking mom down now. It was 8am.
After sighing in frustration, we both boxed up our breakfast that we had not
yet touched and took them back to mom’s room to see her off.
We walked down
with her to see where the endo waiting room was. Dad was informed then that he was allowed to
stay with her in the prep area until they took her down for the procedure, but
that the room was small so me and Kailey would have to wait in the waiting
room. And we waited, and waited, and waited…. 1200pm came around and we were
still waiting to hear from dad. It had been 4 hours she had been in the prep
area. Finally, the charge nurse came in and apologized and said that they were
hoping the could jave gotten her back earlier but that it should be just after
the next case. We all decided to go on to lunch and hopefully mon would be taken
down when we came back.
After almost 5
Hours of waiting They took her down at about 12:50pm. We waited for forever in a consultation room
waiting on the doctor to brief us on what he found. Finally around 4:00pm Dr Ahmed walked in the
room with a large role of ultrasound pictures and some color photos from her
ERCP. He started very calmly to go
through each picture telling us that everything in these pictures were normal.
He got most of the way through the huge roll of ultrasound pictures and we were
all thinking, this is great!
Then he got to a
picture and stated, “and then I see this black spot, and I don’t like that…” He
proceded to tell us that they aspirated some cells from the block spot on the
sonogram picture and that, “unfortunately she does have adenocarcinoma of her
pancreas.” Bomb dropped. The girls started to cry, my dad held his
hands to his face, I was numb. Worst news we could have gotten. Dr Ahmed went on to say that the mass was
abutting the portal vein but that he did not see that it had gotten into the
vein, but that he couldn’t be sure. If it had, he stated that we might have to
try to shrink it with chemo and radiation first ti see if it could be brought
to a point where they could try to take it out.
Dad asked about mets… “we will do a CT scan, probably tomorrow, and that
will tell us everything we need to know about whether or not it is operable or
not. It will also tell us if it has metastasized anywhere else.”
We were able to go
back to see mom in recovery shortly afterwards. There we a lot of tears and
heartache, but soon we had her back in her hospital room. We spent the evening, after she woke up good
from anesthesia laughing and carrying on as we normally do, watching funny videos
on facebook and enjoying time together. As Sheila, Kailey and I got on the elevator
late that night to head to the hotel we all looked at each other, and I said
it, though everyone was thinking it… “Today was a VERY bad day.”
October 6th, 2016
Kailey and I woke up early this morni g to go
see mom. Dad had left to go home and
pack a better bag and pay some bills, etc… so it was just kailey and I
there. Mom looked like she felt
miserable. She was having really bad
abdominal pain. Turns out that Dr Ahmed
was unable to place the stent in her biliary duct to relieve her jaundice
during her ERCP yesterday. He tried multiple times. After several attempts he
decided to let her rest and try again on Friday, october 7th. As a
result of all the manipulation of her pancreas yesterday she had developed an
acute pancreatitis. Her lipase (and
indicator of how your pancreas is feeling) which is normally 10-70 was over
4,000. Suffice it to say, her pancreas
was angry. To treat this they have
increased pain medication and are forcing IV fluids at 200 cc/hr which is quite
a lot.
When Kailey and I
arrived at the room mom was already gone down to have her CT scan done – the
one we were dreading. We waited for her
to return, which she did about 30 minutes later. We had no sooner gotten our hugs and good
morning’s in when two doctors walked in the room. My heart sank… Kailey turned green… mom held
her breath. “My name is Dr.
Christein. We have looked at your CT
scan”
All time stopped
for the three of us in that moment. Please God. Be good news. We need just one
break, PLEASE. “After looking at the
CT, I don’t see and mets anywhere, your liver, gut, and lungs look fine and
clear.” Immediate praise. Thank you
Lord! “Also, I think that we will be able
to get all of this cancer out, so we will plan for surgery on Monday or Tuesday
of next week.” Kailey, Mom and myself
hugged, cried and thanked God for the Best worst news we had ever
received. Being an oncology nurse myself
and having done extensive research on pancreatic cancer since her diagnosis
yesterday I knew that statistically only about 10% of all pancreatic cancers at
tge time of diagnosis are considered resectable. We finally got a break. I asked about staging the cancer. Dr
Christein stated, “Well, I’m just a surgeon but I think it would be stage 1 or
2.” Wow. What hope had been given
us. Now we have a plan. Surgery Monday, recover, and chemo. Hope
springs anew.
October 7th, 2016
Mom is feeling
much better today. Her spirits are much
improved and there is a sense of hope that abounds. In addition , her lipase is down to 800,
which is still way too high but much better than 4,000. She has showered and put on a t shirt and fixed
her hair (which she has been SO worried about!) And is having a lot of company
today, friends and family alike. Several
groups of doctors have been back in to see her that have reaffirmed what Dr
Christein told us yesterday – no mets and removeable cancer. The rest of the day was spent visiting and spending
time with those that love us and have turned out something fierce.
Special thanks to all of the people that have come up to see
Mom and Dad the last few days. It has
meant more to them than I can express.
Special thanks to Paul Johnson and Rick Church, for visiting, but also
for being there for my Dad in a way that I could not be. God bless you all!
As Kailey said yesterday,
the journey begins. This journey ends in
victory! I CLAIM IT IN THE NAME OF JESUS!
- - Luke