Friday, January 23
After another great breakfast at the trendy little Emory Village restaurant, Rise and Dine, Mom and I entered Dad's room in time to meet Dr. Kauh (pronounced "Ko"). He is a hematologist/oncologist at Emory. In Dad's recap to the doctor, I heard for the first time that the original tumor targeted by the surgery was actually larger than the scope showed. It was longer, 2.2 cm.
Dr. Kauh agreed that the node with the tumor being close to the first tumor was good. He said radiation is controversial. Europeans don't believe in it. They chose to do their trials with chemotherapy, Gemsar, alone. The German study, which included hundreds of patients, made much more sense, however, than an American study which only used 43 patients, due to the doctors' bias against enrollment.
Chemo and radiation had been standard care until the last three years. In 2003, patients treated with chemo only did best. Chemo plus radiation was 2nd to last. Dr. Kauh's inclination with clean margins like Dad's is to shy away from radiation.
The regimen he uses--standard with most oncologists currently--is Gemcitabine (produced by Eli Lilly as Gemzar) . Most patients respond with few side effects. Normally they experience flu-like symptoms for two or three days after treatment. The protocol is once weekly for three weeks in a row, then one week off. Blood counts are taken to ensure the patient remains healthy.
This goes on for six months, with a total of 18 treatments. The window after surgery is 4-8 weeks, depending on the individual's progress.
The doctor told Dad he was doing great, with no IV (the nurse removed it today but kept the connection in case needed) and no nasogastric tube.
Dr. Kauh was very matter-of-fact, reminding Dad that pancreatic cancer has a high propensity to recur. But he also pointed out that out of all 30,000 cases diagnosed annually, only 15% are local tumors which are operable. Of those, only 10% will be resectable (able to put remaining parts of pancreas back together with other organs). So Dad is already in the top 10% of pancreatic cancers.
After the doctor left, Dad told us Wendell had called. He had eaten a few bites of scrambled egg for breakfast, along with a little biscuit and a fair amount of grits.
Rolanda came in to take Dad's vitals and told us she loved Chattanooga and had visited many times.
Dad's lunch tray arrived. Food, drink, even water, tasted funny to him, probably side effects of meds and anesthesia. He did eat a smattering of most of the foods and requested a chocolate milk, which showed up an hour or two later.
Dad and I took the usual walk. He was eager to talk about the iffy prognosis and the fact that instead of the actuarial prediction based on his overall health and condition that he might live 9 more years, perhaps he only had 5 or less. Yet he really didn't know.
He said, "This puts my life in perspective. I know my time may be more limited than I thought. The important thing is to live each day as though it's your last. I need to find out what the Lord wants me to do in the time I have left--and do it."
After his walk, the pain meds started to kick in, a good thing with his incision hurting, so he settled in for a nap.
Later, Gary came and entertained us with funny stories about Trey and the pictures on his camera of his family taken by a photographer friend last weekend when their whole family was together.
Mom and I met Gary, Sherry, and Laney at Athens Pizza for dinner, and we laughed some more.
As Mom and I made a couple of errand stops on the way back to University Inn, she expressed her fears and shock.
"You know, I thought maybe one day your dad would have to have open heart surgery. But I never dreamed of anything like this. I don't think he's really grasped it yet."
I told her, "I think denial is normal. I'm not thinking of it as real yet myself. I know what the statistics about pancreatic cancer say, but I also know that God is greater than statistics, and people are individuals."
It was good to talk to Flavia today and touch base with home folks. I was glad to speak with Billie about her loss, knowing we are not the only people going through difficult times.
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