Dad returned to work Monday. The staff had left balloons in his office. He was glad one of the doctors who'd filled in for him during his recuperation from surgery could help him catch up.
I haven't gotten a report on how yesterday went, but Steve and I, along with Toney-Paite, Skylar, and Grantland, our "grandkids" from one of our Key Club "children," stopped by for a visit to Mom and Dad on Sunday.
Dad says he's gained five pounds and looks great. He's ordered (rather, had Mom order) a Jack LaLanne juicer to put the antioxidants in veggies to work destroying cancer cells!
His first chemotherapy infusion is Friday afternoon at 3:00. Prayers are appreciated!
Thanks to all who've been following Dad's adventure, especially for your loving concern shown by your notes, calls, visits, and mostly, prayer.
Wednesday, February 25, 2009
Saturday, February 14, 2009
Out of Denial, into Light Both Harsh and Sweet
Saturday, February 14
It was as if my mind and emotions sat paralyzed after we returned from Emory. I didn't want to deal with all the spoken, unspoken, and contradictory possibilities. Weary with the long haul at the hospital and discouraged by varying prognoses from different sources, Dad was depressed, especially about his lack of appetite and energy, and Mom and I oscillated between laughing at his impatience and odd eating experiments and tearing up over the thought of losing him.
On Monday the 9th I met Mom and Dad at the oncologist's office. Though he seemed very nice, Dr. Schlabach was not overly encouraging, I suppose because he didn't want to give us false hope, considering the nature of the beast called pancreatic cancer. The reality of chemotherapy sank in as we visited the large living-room-like area where patients received their chemo infusions. In a couple of weeks, Dad would begin.
Dad inquired about his lack of appetite and subsequent weight loss after surgery. Dr. Schlabach prescribed megase/megestrol, saying, "You need to reverse your weight loss before you begin chemo treatment."
They discussed the regimen, which Dad preferred to do on Friday, in order to recover over the weekend for work the following week. The protocol the doctor follows calls for 3 weeks on, one week off, for a total of 12 treatments over 4 months. The first treatment was scheduled for February 27. Each infusion would take 30 minutes.
Dad asked if he would be able to drive himself to and from the treatments. Dr. Schlabach said,
"See how you feel after the first time."
What side effects could he expect? Usually patients were tired a few days afterward, but most effects were mild. Rarely did patients treated by Gemzar experience nausea, and few lost hair. The blood count could be affected, mostly platelets, but also sometimes the white count. This would be checked prior to treatment. Some patients had fever, ankle swelling, fatigue, sometimes difficulty with wounds healing.
The effectiveness of gemcitabine can increase survival up to 3 years. Good margins from the excision of the cancer--which Dad had--give 23-31% survival, if the drug is administered to all patients. Resectable pancreatic cancers such as Dad's are all potentially curable. Dr. Schlabach felt the lymph nodes, of which Dad had one out of 29 positive, trumped all other factors.
Statistics. Numbers. Not necessarily individual reality.
************************************************************************************
Wednesday, February 18
Last Wednesday, the 11th, Mom, Dad, and I returned to Emory for Dad's checkup with Dr. Sarmiento. We stopped in first at the Clinic's lab for the usual pricks and sticks and shot glasses of glucose.
Dad, of course, had plenty of questions for Dr. Sarmiento, who had returned to work, still sick, after going home earlier to rest:
1) Prognosis?
Dr. Sarmiento, like Dad, felt the tumor originated from the IPMN. Proximity made that the likely scenario. This would mean better chance at survival, a good shot at 50%, because the two types are different animals.
The pancreatic pathologist, Dr. Sharma, had pointed out the anatomic path, from the tumor to the nearest lymph node, the only positive one. Dr. Sarmiento encouraged Dad to give her a call.
He indicated the protocols now are to remove more and more nodes. There was no question in his mind he had sampled every lymph node possible from Dad's surgery. He said the studies Dad had looked at had taken place 10-12 years back from the time they were published, so the data for pancreatic cancer survival could be different now. That implied BETTER OUTCOME--but he didn't say that.
2) Appetite?
Dad was concerned about his weight, weight loss, lack of appetite, and lack of energy. Dr. Sarmiento smiled and said, "The two main complaints of patients who undergo this surgery are:
lack of appetite and lack of energy. One day, you'll wake up, and you'll feel different."
3) What activities?
Dad wanted to know whether he could drive or take a tub bath. Dr. Sarmiento said as long as he was off the pain meds, he could do what he felt like doing. He encouraged him to continue his follow-up with the oncologist, typically at 3 months, then again 6 months later, with CT scans when the doctor felt they were appropriate.
Dr. Sarmiento reiterated that all the side effects Dad experienced were normal: fatigue, no appetite, cramping, and soreness. He reminded Dad that only 20-30% of his pancreas had been excised, in the head, and thus he only has a 5% chance of becoming diabetic.
The overall visit was encouraging. Dad celebrated by eating almost a full order of onion rings at IHOP, as well as a pancake breakfast with eggs and bacon. (He didn't eat all the onion rings, because I sneaked two of the small ones.)
A few days later, Dad talked to Dr. Sharma, seeking her confirmation of his chances for survival and a cure. She finally told him, "You're doing well. Just go live your life." And she's right. Steve pointed out he could be jerked around by every opinion he solicits and every study he reads. Tomorrow the Rapture could occur or we could be killed in an accident. There are no guarantees for any of us. That's why we need to make the most of each day.
Meanwhile, Dad has Mom on the internet ordering him books and a Jack LaLanne juicer. Seems he's found this antioxidant vegetable juice recipe that kills cancer cells...but, hey, why not give it a whirl? In the blender.
And he plans to return to work Monday. Good. Now Mom can rest.
Next week--the first gemcitabine [chemotherapy] infusion on Fri., Feb. 27.
It was as if my mind and emotions sat paralyzed after we returned from Emory. I didn't want to deal with all the spoken, unspoken, and contradictory possibilities. Weary with the long haul at the hospital and discouraged by varying prognoses from different sources, Dad was depressed, especially about his lack of appetite and energy, and Mom and I oscillated between laughing at his impatience and odd eating experiments and tearing up over the thought of losing him.
On Monday the 9th I met Mom and Dad at the oncologist's office. Though he seemed very nice, Dr. Schlabach was not overly encouraging, I suppose because he didn't want to give us false hope, considering the nature of the beast called pancreatic cancer. The reality of chemotherapy sank in as we visited the large living-room-like area where patients received their chemo infusions. In a couple of weeks, Dad would begin.
Dad inquired about his lack of appetite and subsequent weight loss after surgery. Dr. Schlabach prescribed megase/megestrol, saying, "You need to reverse your weight loss before you begin chemo treatment."
They discussed the regimen, which Dad preferred to do on Friday, in order to recover over the weekend for work the following week. The protocol the doctor follows calls for 3 weeks on, one week off, for a total of 12 treatments over 4 months. The first treatment was scheduled for February 27. Each infusion would take 30 minutes.
Dad asked if he would be able to drive himself to and from the treatments. Dr. Schlabach said,
"See how you feel after the first time."
What side effects could he expect? Usually patients were tired a few days afterward, but most effects were mild. Rarely did patients treated by Gemzar experience nausea, and few lost hair. The blood count could be affected, mostly platelets, but also sometimes the white count. This would be checked prior to treatment. Some patients had fever, ankle swelling, fatigue, sometimes difficulty with wounds healing.
The effectiveness of gemcitabine can increase survival up to 3 years. Good margins from the excision of the cancer--which Dad had--give 23-31% survival, if the drug is administered to all patients. Resectable pancreatic cancers such as Dad's are all potentially curable. Dr. Schlabach felt the lymph nodes, of which Dad had one out of 29 positive, trumped all other factors.
Statistics. Numbers. Not necessarily individual reality.
************************************************************************************
Wednesday, February 18
Last Wednesday, the 11th, Mom, Dad, and I returned to Emory for Dad's checkup with Dr. Sarmiento. We stopped in first at the Clinic's lab for the usual pricks and sticks and shot glasses of glucose.
Dad, of course, had plenty of questions for Dr. Sarmiento, who had returned to work, still sick, after going home earlier to rest:
1) Prognosis?
Dr. Sarmiento, like Dad, felt the tumor originated from the IPMN. Proximity made that the likely scenario. This would mean better chance at survival, a good shot at 50%, because the two types are different animals.
The pancreatic pathologist, Dr. Sharma, had pointed out the anatomic path, from the tumor to the nearest lymph node, the only positive one. Dr. Sarmiento encouraged Dad to give her a call.
He indicated the protocols now are to remove more and more nodes. There was no question in his mind he had sampled every lymph node possible from Dad's surgery. He said the studies Dad had looked at had taken place 10-12 years back from the time they were published, so the data for pancreatic cancer survival could be different now. That implied BETTER OUTCOME--but he didn't say that.
2) Appetite?
Dad was concerned about his weight, weight loss, lack of appetite, and lack of energy. Dr. Sarmiento smiled and said, "The two main complaints of patients who undergo this surgery are:
lack of appetite and lack of energy. One day, you'll wake up, and you'll feel different."
3) What activities?
Dad wanted to know whether he could drive or take a tub bath. Dr. Sarmiento said as long as he was off the pain meds, he could do what he felt like doing. He encouraged him to continue his follow-up with the oncologist, typically at 3 months, then again 6 months later, with CT scans when the doctor felt they were appropriate.
Dr. Sarmiento reiterated that all the side effects Dad experienced were normal: fatigue, no appetite, cramping, and soreness. He reminded Dad that only 20-30% of his pancreas had been excised, in the head, and thus he only has a 5% chance of becoming diabetic.
The overall visit was encouraging. Dad celebrated by eating almost a full order of onion rings at IHOP, as well as a pancake breakfast with eggs and bacon. (He didn't eat all the onion rings, because I sneaked two of the small ones.)
A few days later, Dad talked to Dr. Sharma, seeking her confirmation of his chances for survival and a cure. She finally told him, "You're doing well. Just go live your life." And she's right. Steve pointed out he could be jerked around by every opinion he solicits and every study he reads. Tomorrow the Rapture could occur or we could be killed in an accident. There are no guarantees for any of us. That's why we need to make the most of each day.
Meanwhile, Dad has Mom on the internet ordering him books and a Jack LaLanne juicer. Seems he's found this antioxidant vegetable juice recipe that kills cancer cells...but, hey, why not give it a whirl? In the blender.
And he plans to return to work Monday. Good. Now Mom can rest.
Next week--the first gemcitabine [chemotherapy] infusion on Fri., Feb. 27.
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