ERCP Success, I think

Well, as I am home and recovering, I presume that the ERCP was a success.  Unfortunately, MaryBeth was off taking her sister, Cat, and her husband, Stan, to the airport when the doctor finished up.  He had left by the time I was awake and MB got back, so I’m not sure what he found about the flow through the bile duct.

Right now I’m tired and my throat is sore, which is to be expected given they had to intubate me (give me a breathing tube) because they used general anesthesia on me and THEN put the endoscope down my esophagus.  I’ll take it easy tomorrow, working from home, and I should be good to go for my CT-scan on Thursday.

What does it say when I walked into the Day Surgery section of Gwinnett Medical and the nurse greeter called me by name and suggested that she was going to get me a ‘Frequent Patient’ pass??  :-)   Hopefully, though, this will be my last ERCP.  Don’t get me wrong, Dr. Kulkarni has been great.  He has taken great care of me, but it is my sincere hope that the tumor has shrunk enough so that surgery is possible.  Presuming that is the case, the tumor will be removed, along with the bile duct, possibly part of the stomach, and likely part of the small intestine.  (If there is no bile duct, then I will not need another ERCP.)

As much as I am hoping that I become a candidate for surgery, I also spent some time today thinking about the complexity of the Whipple Procedure.  Up until last year, I had never really had ANY surgery.  Then I had rotator cuff surgery in February, 2007; gall bladder removal in August, 2007; and 6 ERCPs (which, I guess is not technically surgery, but close enough in my book).  But all of those experiences PALE in comparison to the invasive nature of the Whipple.  Up until now, I haven’t had to really think about the surgery, as it was always something that would happen down the line.  Now it’s (seemingly) staring me in the face.

I’m trying to stay present and not worry about it too much.  I’ll know more after next week, but still it’s odd to be hoping to undergo the surgery.  I know the Whipple is my best chance of surviving this cancer, but I’m not relishing the idea of staying in the hospital for a week or two (at best — and possibly longer).

Perhaps I’ll just worry about that later, eh?  Thanks for checking in on me.

Merle

Tags: Main, Treatment by Merle
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What’s next?

So I got up today to go work out; 5:30a came very early!  I made it to the gym and did the first half of my workout (weights), but I did not have the energy to do my cardio.  I was so bummed.  It’s funny how a perfectly good day can be “ruined” by something as silly as not having a good workout.

At the party, several people asked what comes next, so here’s what’s on my medical plate for the next couple of weeks:

  • Tomorrow (well, today, actually — 7/22) I am having an ERCP to replace the stent that is currently in my bile duct.  As a potential test of whether my tumor has shrunk any, I’m going to ask the gastroenterologist (Dr. Kulkarni) if he will see if there is any flow when he takes the stent out.  Essentially, before chemo/radiation the tumor was pushing against the bile duct preventing flow; if the tumor has shrunk, perhaps there will be flow when the stent is removed (though, he’ll still put a new stent in).
  • Thursday (7/24) I have my re-staging CT at Emory.  I’ll get a copy of the CD with the images, but I will not get the report from the scan until next week.  (This is code for: “I won’t know anything about my scan until Monday 7/28, so don’t ask!”).
  • Monday (7/28) I meet with the Atlanta-based surgeon (Dr. Sarmiento).  Dr. Sarmeinto was very positive about my prognosis for surgery back in April; hopefully, my tumor behaved itself.
  • Tuesday (7/29), MaryBeth and I fly to Baltimore.  My mother will be meeting us there and hopefully we can get together with my brother, Isaac, for dinner.  Either way, we will be staying near Baltimore’s Inner Harbor, so I’m hoping we’ll have time to visit around there.  (As an aside, the docs at Emory will discuss my tumor at their Tumor Board on Tuesday, too.)
  • Wednesday (7/30), I have an appointment with Dr. Cameron, the surgeon from Johns Hopkins, for a surgical consult / 2nd opinion.
  • Monday (8/4), I meet with Dr. Kauh, my oncologist in Atlanta, to discuss what the surgeon’s said and to make a plan for my treatment.

Beyond 8/4, I have no idea what August might hold.  I have a conference to go in the middle of August which I would like to make if possible, but that will depend on what the doctors say.  I do know that if I have the surgery up in Baltimore, it will likely not happen until after Labor Day, as Dr. Cameron is out of the office on vacation the 2nd half of August.  In deference to the folks at Hopkins, though, I really (REALLY) hope I can have the surgery down here in Atlanta.  It would be SOOOO much more convenient.  We shall see!

Merle

Tags: Main, Treatment, Work by Merle
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