Finished 8th Chemo Yesterday

Dr. Picozzi was off duty yesterday because he has New Year’s Day coverage.  We consulted Dr. Lin, his partner, and he astonishingly was well up-to-date as to my status.  He had the same opinion that as this very aggressive cancer is not any worse, is a very good indicator of “good news.”  He related that although the cancer marker CA19-9 is a “vague” indicator, nonetheless, that it is treading down is “GOOD”.  The normal level is 35, yesterday my reading was 15.1, down from 18.6 last week!

We also learned yesterday that the total treatment regiment is 16 rounds, not 18 as inferred by us previously.  This means I am now already half way completed.  I have to say. the first half has been totally tolerable.  The greatest puzzle to me has been that the responses in terms of my reactions and side effects have not been anywhere the same after each of the 8 treatments.  The latest response was nothing but fatigue and desire to sleep this past week.  My appetite is good, although food tastes differently, and I continue to gain weight slowly.  Last week Linnea has been “pushing” protein on me since my blood albumin and blood protein were heading below normal.  Test yesterday showed a reversal.  Guess I need to listen more and do what she says.

A Most Happy and Healthy New Year!!

💜💜💜💜Gong Xi Fa Cai to All💜💜💜💜

Report after F/U CT scan

Let me begin by thanking everyone who has been interested enough in my health progress to visit this site for information.  I have been informed that I have many visitors, though less leave comments.  That’s all good.

Yesterday I had a repeat chest and abdominal CT scan prior to initiating the 7th Chemo (of 18) treatments.  As a physician, I had more expectations of modern technology than I should have had realistically.  The general report is that even with this very aggressive Adenocarcinoma the picture is no worse than before treatment.  (Somehow, I was hoping to see more definitive improvement.)  The report indicates that the tumor borders are no longer distinctive, so now it is more difficult to distinguish tumor/normal.  Is this good or bad?  Linnea reminds me that the tumor markers have continue to drop from an initial 68.1 to 18.6, YaHoo!

Good signs are many.

  1. My appetite, weight, mental ability are all stable.  I seldom feel nauseous and have not vomited at all.
  2. Although my energy level fluctuates, I am still able to play a round of golf about once a week.
  3. My blood cell counts are reduced, but still good enough to maintain myself.
  4. Because of my lowered blood chemistry, I am allowed to eat meat/eggs as I please.

Bad signs are a few.

  1. GI system is greatly affected with little control of gas, BM like prepping for colonoscopy weekly.  Gas-X, Beano and probiotics do help.
  2. Recently, the chemo has dried up the secretory cells like the salivary glands and other glands along the wind pipe.  The dried mouth and throat are sometimes very troubling, causing inability to sleep more than 15 minutes.  Sipping liquid lasts only second!  I lost my voice, sad especially because Christmas carols are my favorite songs.  However, thankfully so far, I don’t have any sores or pain that other patients experience with chemo.

6 Sessions of Chemo completed

December 7 :  Today I finished my 6th chemo treatment, and I may say that I have thus far tolerated all 6 treatments very well.  This marks 1/3 along the Chemo journey.  I have not only maintained, but managed to gain a few pounds.  My only visible sign of illness is I am very thin-haired and whatever hair left are all white now!  My blood works show a decrease in red, white and platelet counts.  Though my energy level seem good, I do tire easily and nap frequently.  I try to walk one mile a day and try a round of golf once a week, weather and symptoms permitting.

In two weeks, before the 7th treatment, I’ll get my repeat CT Scan.  Can’t wait for the results.  All indications should show improvements.  Best luck to me.

Health History

Beginning around early September 2015, I had a gnawing ache at the L front midsection.  I was monitoring this symptom thinking that this was the beginning of a gastric ulcer, but fearing that I was developing a stomach Cancer!  Surprisingly, however, this ache had little relationship with my food intake.  The symptoms were very mild and totally tolerable.  I continued all normal activities including golfing 2x per week!

Also around the second week in September, I noticed that my urine was turning dark, sometimes very dark, like Stout amber beer!  This sign persisted in varying degree (depending on my fluid consumption) without any other symptoms like discomfort or pain whatever.

My life was busy and full.  I am a member of the Compass Housing Alliance, a Lutheran Social agency serving the Seattle homeless.  I am also on the NW WA ELCA Synod Council and on its Executive Committee.  Furthermore, Linnea and I were scheduled to “grandparent” Mira and Saya, our granddaughters in Boston during the last week of September while daughter Dr. Catherine Chu fulfills her duties as the oncall attending physician for the Neurology Department at Mass General Hospital.  We had a great visit with the girls and returned to Seattle on September 28th.

While in Boston, I related my signs and symptoms to Linnea, and she insisted that I make an appointment with my PCP Dr. R Hurlow, asap upon our return to Bainbridge.  Well, I was determined to play my round of golf previously scheduled for Thursday so I scheduled to see Dr. Hurlow at 8am, Friday 10/2/2015.

Friday evening, around 8:30pm, Dr. Hurlow and I finally made contact and he told me that my liver function tests and my blood amylase levels were 20-30x greater than normal !!!  He went ahead and scheduled a CT scan for me for Monday 10/5 in the morning.  After the test, the radiologist discussed the “bad news” with me.  I had grossly visible obstructions at the bile, gall and pancreatic ducts.  The most likely diagnosis is Pancreatic Adenocarcinoma situated at the head of the pancreas.

Wednesday the 7th, I gave my first of a series of four lectures: “Eyes and Seniors” on “Cataracts” at the local Community Center.  Then I abruptly cancelled the remainder.  Although later, I contacted Dr. Jackie Wong who so kindly consented to lecture on “Macular Degeneration” in my place.

Next day, Thursday, 10/8, via arrangement made through Dr. Catherine Chu and the chief surgeon of the Biliary Surgical Department at MGH, we had a consultation with Dr. Scott Helton, chief surgeon of Pancreatic Diseases at Virginia Mason Hospital.  Thorough and Compassionate, he spent over two hours with us; answered all questions posed by my sister Elizabeth, son David, Mom Shirley as well as Linnea and me.  Then he had a CT scan of my thorax taken on the same day.

Friday, we returned to VMH and had Endoscopic ultrasound to delineate borders and margins of involvement, had a needle biopsy of the lesion and a metal stent placed in the bile duct to drain the liver and gall bladder obstruction.

PO Day 1, Saturday.  I experienced severe stomach cramps, 6-7/10 on the pain scale.  Seriously, if pain persisted like this, I wondered how anyone could tolerate this much pain through Chemo!!  That night, sleepless, I thought of my early days in Springfield and decided to write a note of thanks to some of my first friends in the USA.  But, almost like magic, once the gall bladder discharged its backed-up contents sometime early morning and the pain disappeared.  I was totally pain and cramp free.  Serious thought crossing my medical mind at this time was a real fear that the stent was extruded!!

Sunday was a welcomed day of rest.

Monday 10/12    Dr. Helton, surgical chief resident, 1st year surgical resident, and a 3rd year medical student with nurse anesthetist and anesthesiologist performed laparoscopy, peritoneal lavage for cytology histology and the placement of a Power Port below my R clavicle for any ingress/egress procedures requiring a blood line.

I rested one week to allow all the wounds to heal.  Feeling better and more energetic daily, we decided to pay a visit to Portland on Thursday to make a call on Linnea’s mom Enz, 95, sister Karen and brother Jonathan/Dorine.  Friday and Saturday, Linnea and I took a short respite through northern OR coast and the Columbia River basis, Lewis and Clark country.  We rested, returned ready for battle on Sunday afternoon.

Betsy stopped by to play a few favorite songs for me to record my voice before Chemo changes it.  I tried, but am afraid the trans-tracheal anesthesia already had its effect.

Sunday evening was spent with friends…. Swartlings, Stumme-Diers, and Ballaines.  Best medicine.  Shrimp cocktails, Halibut cooked to perfection, fresh organic greens and pear tart.  Can life be any better?!!

Monday, 10/19 The Chemo treatment begins!!

Another outstanding experience at VMH.  The nurse, dietician, medical staff were all kind and gentle.  Prepped me with meds before infusion to the point that I slept and snored 2 out of 3 hours of the process.  I had no ill effects whatever, so we decided to meet up with Son David and Granddaughter Fiona for BD dinner.