Day 9 - The Plan

OK, so I'll just dive right into this (as there is really only a "deep" end.)

This morning Mel and I drove down to MUSCs Ashley River Tower so I could get a CT scan of my chest, abdomen, and pelvis. Other than the really disgusting stuff I had to drink before hand, this all went off without a hitch - lasting only about 10 minutes total for the scan. We then moved the car to a different garage a couple of blocks away so as to access the Hollings Cancer Center. This is where my first meeting with Dr. Chin the Oncologist was to happen. Everything timed out perfectly and we arrived right on time. Oh, interesting side note and the first benefit realized from my Handicapped placard - they can't charge you for parking in downtown Charleston if you're handicapped. Free parking - find that in Boston!

In any case, we met with Dr. Chin. We both liked him very much. He seems more than qualified and didn't talk down to us. And, as Mel says, "He doesn't look twelve" like so many of the doctors I saw while in the hospital did. Here's what I we know:

I've got Stage IV Adenocarcinoma. The tumor is located on the top outside of the stomach near the bottom of the lungs and the liver. The tumor is surrounded by fluid that contains abnormal cells. It's because of this fluid and the spreading cancer cells that the cancer is considered Stage IV which essentially means it is in-operable. At this point, surgery is not an option and most likely never will be. A cursory look at my CT scan shows no cancer in either the lungs or the liver but there are some "suspicious" masses growing on the outer lining of my small intestine - further analysis is needed. As the only true cure for Adenocarcinoma is surgery and as that option is not available, we will concentrate on prolonging my life (at a decent quality of living) for as long as possible. How long that will be remains to be seen. There are five types of chemotherapy that are useful against this type of cancer but two of them rely heavily on the kidneys to filter them out so we'll avoid those until my kidney function edges back closer to normal. Of the other three, two are filtered primarily through the liver. We'll start by trying one of these and then, depending on how well I tolerate it, move on to a cocktail of two or three. Usually the chemo would be administered every two weeks, but given my weakened state, the Doc decided it would be better to administer lower doses weekly. He thinks I will tolerate it better. I go back in a week to have some blood work, review the treatment plan with Dr. Chin, and then receive my first dose of chemo.

I think that's everything. Keep the good thoughts and prayers coming.

Be Well.

Chris

Day 5 - No News / Good News

Earlier today I got a phone call from one of the nephrologists (kidney doctors) who told me that my blood labs from yesterday showed continued improvement with my kidneys and that I no longer needed dialysis (yeah!) I am now to be followed by my regular nephrologist in clinic on a regular basis. This is the good news for the day.

I also received a phone call from the Oncology department regarding an appointment on Tuesday. I'll go in and first have a CT scan and then have an appointment with Dr. Chin. I am hopeful that we will have some answers regarding treatment and prognosis after this meeting. Good, bad, or otherwise - I don't care at this point, I just want to be able to move forward with some knowledge. I want to know what I'm up against.

Sometimes no news in not necessarily good news. That's fine - just give me some news; any news.

I doubt I'll post again until after my Tuesday appointments.

Be Well.

Chris

Day 3 - The Label

So with a new day comes a new attitude. I'm in a much better mood than I was yesterday. Thank you to everyone who left encouraging thoughts in response to my previous post.

As of today I still haven't heard anything from the hospital regarding my followup appointment with Oncology. I called a contact at the hospital and told her that I didn't really feel like time was on my side in this case and that I was going a bit stir crazy waiting for some word regarding my pending appointment. Hopefully that will yield some results.

In mail today came my bright shiny new Handicapped Placard. I was happy to receive it as long distance walking is still quite taxing on me. But I found it mildly disturbing to refer to my self as handicapped. All of a sudden the word takes on a new, slightly derogatory meaning. I can understand why people prefer to be referred to as disabled. I'd much rather be disabled than handicapped. In fact, there are a whole slue of labels I'd much rather have - disabled; other-abled; irregular; heck, even slightly damaged goods would be better than handicapped. Oh well, I guess I'll have to live with it.

I ran down to Lowes to get a blade for our mower and took my placard with me. The only thing stranger than being referred to as handicapped is actually using a handicapped parking space. I was so paranoid that everyone was looking at me and saying, "That guy doesn't really look handicapped." So, just to be sure, I shuffled along dragging on leg in a Verbal Kint sort of manner.

You all will know more when I know more.

Be well.

Chris

Day 1 - And So The Journey Begins

Yesterday, August 23, 2010, Mel and I arrived at MUSC's Ashley River Tower at 7:00am so that I could have an Endoscopic Ultra Sound of my stomach. This test was ordered because of a 6 cm polyp that was discovered during a previous Endoscopic foray into my GI track. The Docs got a piece of the polyp but they weren't convinced they had the whole story and wanted a better look. The EUS would afford them the opportunity to see through the stomach lining and into the tissue beyond.

We were registered quickly and taken back to the prep/recovery area. An IV was started and some blood was taken for labs. Everything was going as planned until the labs came back. It turns out my hemoglobin was too low (6.2) for them to do the procedure. The EUS would have to wait until after I could get a couple units of blood transfused into me. The good news from the labs was that my kidneys were working well enough for me to not need dialysis (for those who are keeping score, I haven't needed dialysis since last Wednesday - yeah!) At first the plan was to admit me to the hospital for the transfusions and do the EUS the day after but Mel put her foot down and said, "No." She made them figure out a way to do everything as an outpatient (thank God she was there.) And, in fact, once they had done as she requested, it turned out that I could get the blood I needed and still have the procedure done on the same day. So I sat for about three hours in a most uncomfortable reclining chair while the blood slowly dripped into my veins. For those of you who have never had a transfusion, let tell you that there is no better drug for making you feel better, stronger, healthier than human blood. It really is the elixir of life. Before my transfusion I could barely make it from the wheel chair to the recliner - afterward I felt like I could jog back to the waiting room. Great stuff blood - those vamps know of whence they speak.

But the transfusion is not the reason for this diatribe. No the real story lies in the results of the EUS. The procedure itself went quite well. I was put under a general anesthesia (thankfully) and the whole thing came off without a hitch. The procedure took about an hour from beginning to end and this afforded the doctors plenty of time to poke and prod and snap pictures and buy souvenirs and try to find a reason to justify this little trip into my digestive tract. As it turns out, the doctors did find something. Just beyond the lining of the stomach and under a layer of muscle is a layer of cancer cells. They took a biopsy and we'll hopefully know more in the very near future. It is quite possible, and most likely, that this stomach cancer is the reason I've been having so much trouble with my stomach. Now I'm in a holding pattern waiting to hear from the Oncologists so we can develop a plan of attack. Generally the protocol is to try and shrink the cancer and then remove it surgically. Thankfully at least my kidneys seem to be rejuvenating themselves (knock on wood - please!)

I've fought the big C twice before and won but I was a much younger man then. I'll fight this as fiercely as I can but, to be honest, I'm not sure how much fight I've got left. Sometimes, when you dodge a bullet, you end up leaning into another one - one that takes its time manifesting its injury.

Keep the good thoughts and prayers coming. Mel and I are really going to need them. And for those of you in the Charleston area who want to lend a hand in some way - I could use some help finding weekday rides to and from the hospital so Mel doesn't have to give up any more of her vacation time.

Be well.