Thursday 4/28/2016

I apologize for the hiatus of health updates since 4/12/2016 for I was doing so well that I had nothing to report.  But my situation changed.  Unexpectedly, starting on 4/19 food that I had ingested began to pile up in my stomach and seemingly stopped moving forward.  Although I ate smaller portions throughout the day, at night prior to sleep, I would have to vomit and the entire day’s intake would be upchucked to relieve the constant bloated sensation that prevented any chance of rest let alone falling asleep.  This happened on a daily basis for a week, even though I was consuming only high protein liquids by the last two days.  Both Linnea and I were a little alarmed that I had lost about 10 lbs during this time period.  I was certain that I was developing scar tissue that was causing a constriction in my new digestive system.  We called the doctors and I was scheduled for an upper GI radiographic exam at Virginia Mason 4/26.

The exam revealed an excellent and healed Whipple anastamosis without constriction, and freely flowing contrast material going through the upper intestine.  The only finding of note is sluggish peristaltic action of the stomach and visible reflux up the esophagus.  Dr. Helton felt this “inactive” stomach is not unusual, but he was concerned of my continual weight lost.  Thus he prescribed new medication to stimulate proper stomach peristaltic action and for me to continue frequent oral intake of 6 meals per day.  Thus far, for whatever reason, since yesterday, I seem to be doing OK and feeling better, so much so that I have sufficient energy to write this report.  At no time in this past week did I feel like sitting down to write.  Now knowing that there’s no problem with the new anatomy of my digestive system, let’s hope that my problem will slowly resolve and I am back on the path to recovery.

Thanks to all of you for your care and concerns.  I apologize again for the delayed health report.

Reflections

My Mom ceaselessly reminds me to be Thankful and be Humble, especially during these last days while I was getting prepared for surgery.  She impressed upon me that I have experienced more than my share of “miracles” and that I should proclaim them aloud and declare God’s Glory … through me.

To start life, I was born a 6-month preemie, weighed in at less than 3 lb.  The doctor basically told my 18 year old mother that I had no chance to live, let alone grow up to be “normal.”  Fortunately, my parents found an experienced “nanny” who had just cared for another set of twins.  She taught Mom to feed Winston and me powdered milk through nose droppers almost continually.  They must have spent every minute of everyday taking care of us and nursed us; by God’s Grace we survived and thrived.  In those days, imagine our living environment as similar to present day situation in Syria.  Warfare surrounded us as the Japanese were invading and bombing China.  But without the “modern science” of heated incubators and the wide usage of unlimited Oxygen for preemies , I was spared blindness and other infirmities.  Instead, I was able to become an Eye MD, a physician who specialized in eye ailments.

I have also reported that when I was nine years old, Winston and I went to fly kite on top of a hill in Hong Kong.  I fell, hit my R temple on something, and was knocked out, turned ashen grey, basically dead.  Again, through God’s Benevolence, Winston and Mom, with the skills of physicians, brought me back.  I experienced amnesia, but again by His Compassion, I was able to re-format and reboot my brain slowly.  Fortunately, I was able to relearn most of what I had forgotten.  It did seem that learning was much more deliberate and intentional than before my fall.

In September 1979, less than one year into starting private practice, while I was leisurely driving to attend a Thursday departmental meeting at Harrison Hospital, I was hit head-on by a drunk driver just as I was entering Poulsbo.  Again I became unconscious.  After a valiant 2-hour effort, the Medics and Firefighters extricated me out of my poor little Chevy Chevette and ambulanced me to Harrison.  I ruptured my spleen, fractured a few protrusions along my vertebrae, cracked a few ribs and twisted the ankles of both feet.  Following immediate surgery and blood transfusion, I survived again, once more intact as new!  In 1979, transfusions were not tested for HIV.  Later on when I decided to get checked was I scared awaiting the result!  Praise Him, I was not affected.

Now I have Pancreatic Cancer.  Again with His Grace and Mercy, I have experienced success each step of the way.  I underwent 12 treatments of Chemo therapy until I developed pulmonary complications.  Then I responded well to lung rehabilitation and was operated on in 7 weeks on April 1, 2016.  I tied the record of earliest discharge post Whipple’s procedure on April 5.  The Pathology report was very good.  The primary tumor measured 1.8 x 1.0 x .08 cm in size, which is relatively small, totally removed.  There was evidence of tumor extension onto the Portal vein and the Duodenum, but all were included in the excised specimen.  Grossly, the surgeon was pleased that he was able to remove all involved diseased tissue.  Most importantly, of the 18 lymph nodes removed, 0 of 18 showed any cancer involvement!!  However, the type of malignancy I have is now classified as Pancreatic Adenosquamous Cancer, one of the worst.

Mom says she’s not surprised.  She reiterated that any illnesses having to do with me just has to be the worst possible scenario.  Don’t you know by now?  God is Great.  He is using you to demonstrate His Mercy, His Grace and most of all, His Love.  Why You?  We may know in due time.

Be Grateful, and Be Humble.  Amen

Tuesday 4/12/16

Post-op appointment was scheduled on this day with Dr. Helton, my surgeon, and for staple removal.  I am really doing miraculously well.  Yesterday, the Pathology report was posted and I  accessed it via my Virginia Mason portal.  It looked very good to me but I needed verification from the expert.  Dr. Helton was all ready to tell me the good news and appeared much disappointed that I already saw the report.  In summary, the best outcome was that I am N-18-0.  That meant all 18 extracted lymph nodes were cancer free.  The tumor itself measured 1.5 x 1.0 x 0.8 cm which is relatively small and was totally removed.  There were slight local invasions of the tumor cells onto the surface of the resected Portal vein and the outer edge of the resected Duodenum.  All good !!

The cell type of the tumor is officially classified as Adenosquamous Carcinoma of the Pancreas, Not a good one to have.  But Dr. Helton said that a) new Chemo will be more effective than what I had used previously which caused me to have pulmonary toxicity b) Squamous cell CA is more amenable to radiation treatment.  Thus, the Tumor Board will meet and make recommendation as to my next course of treatment.  For now, he felt very confident that he had removed all grossly visible pathology.  We know that this disease is insidious.  We’ll go after what microscopic cells that may persist in 4-6 weeks.

I appreciate your continual prayers and good thoughts.  I’m going to break chronology in my report, my Next Biographical entry will document other incidences that Mom says I only get worst cases of life and death experiences so God may demonstrate His Almighty Power through me.  She admonishes me to BE More Humble.

Meanwhile, I am going to attend a Mariners’ game with Pr. Paul and the Rohrscheibs today.  Dr. Helton gave me the OK to pitch and putt, so I’ll do a round of golf doing that with Steve Stenberg on Saturday.

April 6, 2016 Post-Op Day 5

I just wanted to give a brief update.  I was discharged yesterday after the Doctors made their rounds.  The blood work ordered for me showed all results were within normal limits (WNL.)  I was almost wanting to stay another day because of my own stupidity the night before!  When I was told I could start eating ‘real food’, for supper I had regular helpings of mashed potatoes with gravy, roast pork, and a dish of cooked apples.  This is not a big meal in my past, but for the first meal after a Whipple’s that was a big mistake!  I was full and uncomfortable all night, experienced more discomfort than anytime during post-op.

During the early morning rounds, the resident asked and said that if I wanted to stay another day I could.  But, thank God, I was able to work all that food out of my system naturally and by noon I got ready to come home.  Dr. Helton shamed  me in saying “You are supposed to be a smart fellow, and you do know that you have a new gut which needs time to learn to work!  Right?”  I promised no way will I do that again.

We got home without a hitch.  Pr. Paul had already moved a large recliner into my bed room for I needed to sleep rather vertically for a while.  Dan/Sue and Mom arrived, staying a week to help out.  My diet today, 1/2 cup of oatmeal for breakfast, 1/2 cup coffee for snack, 3/4 cup chicken porridge for lunch, apple sauce for snack, and steamed eggs for dinner.   Much more sensible.  I walked the loop around my house twice for exercise, and walked within the house, logging 1.5 miles today.  Not bad for POD 5.  Dr. Helton was as proud as I, saying that I, (his patient) have the bragging rights to have tied the record of the shortest hospital stay (4 days) post-op a Whipple’s procedure.

“Tubeless in Seattle” April 4, 2016

First, let me express my deeply felt THANK YOU to all of you, dear friends and relatives, for your prayers and kind thoughts as well as your continual encouragement.  Your love and support truly have been uplifting for me.

The report from my surgeon, Dr. W Scott Helton is that my procedure went as well as possible, a perfect ‘Text Book’ case.  I had sufficient slack in the Portal Vein to make that anastomoses without having to do a saphenous vein harvest which could have prolonged the procedure another 2 hrs.  As it was, I was ‘out’ by anesthesia at 8:40, surgery began at 9:20, and was completed at 5:35.  I awoke @ 6:25 surrounded by medical personnel then family members by 6:37.  The ‘Michael Jackson’ drug works great!

My recovery has also been more than smooth.  I’m eating normal low fat, low fiber diet tonight.  All 7 ‘tubes’ I was connected to are out.  I asked whether I could go home tomorrow.  Dr. Helton finds no reason to keep me hospitalized, so he said to plan to be discharged tomorrow; one of the soonest ever after a Whipple’s procedure.

Thank You Lord.  Elizabeth ask if I knew Dr. Helton’s first name?  I said Scott, but it really is William.  So William operated on Franklin!  She thought that was not just coincidence, brother William was also pulling for me.

Again, Thanks and Gratitude from me to All.

April 1, 2016. Surgery Update

Hi from Linnea,

Just met with the surgeon who was very pleased.  Felt it went the best possible.  Tumor is out, no visible signs of further involvement pending lab tests which won’t be available til late next week.  Franklin is still in recovery and will spend night in ICU ( me, too).  Thanks for all your love and support, prayers and good Thoughts. We’re exhausted but happy; large group here since 6:30 am.😃💜💜