Chapter Ten: Can't See the Forest for the Trees

Wednesday, January 21

After a late start and breakfast and a call from Dad to bring bottled waters, we hit the Coin Laundry on North Decatur. Once Mom and I had stashed the dry clothes and hung the damp ones everywhere, over furniture and hangers and the shower, we set out for Emory University Hospital.

Dad seemed okay yet disappointed with the fact that he wouldn't be released on Thursday. He felt pretty sure the doctor would allow him to leave Friday. He caught us up to speed:

1) His epidural was capped, as planned, at 6 a.m.
2) He felt perky at 7 a.m.
3) He disconnected his IV cart, put his robe on, and started hiking.
4) He was rolling along after 6 laps and planned to continue--until he saw his tray arrive at 7:25.
5) He felt fantastic--of course the epidural continued its effects for 2 hours.
6) He ate, and a little pain began to plague him.
7) He had been given two pain pills for the transition, but hurt a little more later.

Mom was chomping at the bit when Dad said he was going to give us an update on the doctor's report. He wanted water first. She accused him of being dramatic, but the pain meds were slowing his thought processes.

Finally he got out that the pathology report was still unavailable. Dr. Sarmiento had come in mid-morning with an entourage, including the intern David Liang and a fourth-year resident, whose name Dad couldn't recall. The bottom line was that there was no way he would go home Thursday. If he was able to eat at the next level and no complications developed, he would certainly be released Friday. They encouraged him to stay around town for a day, to make sure he was okay.

They also discussed chemotherapy with Dad, and he saw it wasn't considered optional, no matter the results of the path report. He would find a place in Chattanooga to receive the Jemsar, alternate weeks. It would probably affect him for two or three days, as most patients had few side effects from this drug, but it could vary. He would need 12 treatments, which would be distributed over six months. The good news? Administered to all patients with pancreatic cancers, no matter the extent, Jemsar doubles the survival rate for a five-year period.

The time he would begin chemotherapy is yet to be determined. He hopes the pathology report is available Thursday. A pancreatic pathologist who works closely with Dr. Sarmiento has been studying the tissue.

Dad mentioned an oncologist in Chattanooga whom he might choose. The protocol for the Jemsar treatments was worked out in Germany. At least four people Dad or Gary have consulted in the past two weeks quoted the German study on the effectiveness of the Jemsar treatments.

One consideration of the timing of the treatments was Dad's work schedule. He wondered whether he could take treatments late in the week and work again by the next week's beginning. Mom and I pointed out to him that it would be difficult to know exactly what worked best until he'd undergone a treatment and seen how it affected him. He agreed.

Dad seemed somewhat discouraged by the news and the lack of news, by the lack of bathroom activity, and by the food. Mom and I hoped for a better day for him tomorrow, though it seemed to be a decent one from our perspective. He had handled very well the transition of the pain meds from epidural to oral. He was eating fairly well.

With two fewer tubes--his catheter and epidural gone--Dad could manage his robe by putting his free arm into the sleeve and draping it over the other shoulder. We walked and talked, as he pushed the IV cart, until the food tray carrier neared his room. He stopped to negotiate with the dietary worker. He wanted a vanilla pudding to replace the chocolate.

We ended up nearly pulling his stitches out while he tried to eat. Mom and I narrated our sighting of a housekeeping cart upturned and the laundry spread out to dry over various furniture. I told a funny story from one of the family vacations Steve and I had taken with our kids. We were all laughing hysterically when Gary walked in.

Mom and I visited a while with Gary, then grabbed dinner while he was with Dad. When we returned, I misunderstood a message from Eric. We waited, thinking he was coming, but a phone call proved it was TOMORROW he'd be in Atlanta. Gary had left. Dad was sleepy and not up to a walk, so Mom and I called it a night.