Bringing Everyone Up To Speed

To Bring Everyone up to speed…

October 3, 2016

                This all started on Monday, October 3^rd, 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 4^th 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 4^th. 

October 4, 2016

                My wife and I arrived at the hospital early in the morning on the 4^th.  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 5^th) 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 3^rd 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 6^th, 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 7^th. 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 7^th, 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