Tuesday, September 30, 2008

Pills . . . (Part 2)

I have never truly understood until the last few weeks how energy draining it is to be in constant pain. Perhaps it's something we can't learn until we experience it for ourselves. And even though the pain I am in isn't excruciating, it still sucks up energy and leaves me feeling wrung out.

Yesterday I saw one of the doctors who works at my GP's clinic because my own GP didn't have an opening. I was prescribed Percocet and started taking them yesterday afternoon. They are working so far, and I don't seem to be experiencing any side effects. Yay! One of the side effects the doctor warned me about, however, I hope to experience - euphoria. I think I could use some of that!

Three more sleeps!

-- L

Sunday, September 28, 2008

Pills . . .

My specialist gave me some painkillers on Thursday and I started taking them Thursday afternoon. I needed to get off the Aspirin because it is a blood thinner, and needed something stronger than Tylenol.

Well, the new pills worked great! No pain! For about six hours.

Then the nausea started. About ten seconds later the projectile vomiting started.

Ah, just nerves, I thought, so I took another dose at the appropriate time.

More nausea followed immediately by vomiting. After about the third go-round with the vomiting, I started feeling kind of weak, lightheaded, and dizzy. Plus, the pharmacist had warned me that the pills would make me sleepy. They had the opposite effect on me and I was awake most of Thursday night. I got about two hours of sleep, from about 4:30 to 6:30 AM Friday morning.

So Friday morning I check out the medication monograph on the Internet. Side effects: nausea, vomiting, dizziness, faintness, rapid heart beat, sleep disruption and some more side effects that I didn't get. And I really felt lousy Friday. I had to leave work about 11 AM because of the number the drug and the lack of sleep was doing on my brain. Couldn't think, straight or sideways. Felt just bloody awful.

Back on Tylenol 1s. As long as I can get through the next four days, I know I'll be okay because they'll give me really good, zonk-me-out drugs in the hospital. They'll have to. After all, they're gonna rearrange my innards!

After getting home Friday I had a quick one-hour nap then was off to the HSC to see the anaesthesiologist and get checked over for surgery. All is good to go.

-- L

Thursday, September 25, 2008

Charlene Gets Evicted October 3!!!!!

Today was the big day to see my specialist and get my biopsy results.

Bad news first: the tumor is definitely cancer. It's the most common type of pancreatic cancer, an adenocarcinoma, which can be quite agressive.

Not so bad news second: the tumor doesn't appear to have infiltrated any important bits of my innards, such as the bile duct, the arteries, or any other organs.

Good news: They gave me some better pain drugs to help me cope with the stupid ache from Charlene leaning on my bile duct. I took one around 12:30; am currently feeling quite painless! The pharmacist warned me no alcohol with this drug. Now I desperately want a gin and tonic! Even a beer would do! I haven't had even a sip of alcohol since June, which isn't a stretch for me, but I tend to crave alcohol when I know I can't have it. Sigh!

Best news last: I am scheduled for surgery on October 3 - that's one week tomorrow. Get ready to wave bye-bye to Charlene!

Those of you who know me well know that I could tell you all the gory details of what they will do during the surgery. I find things like this fascinating, and it's part of my nature to need to know exactly what will be done to evict Charlene. But not everyone wants to know the intricate details so I won't inflict them on you. If you're interested, google Whipple Procedure. You'll find lots of gory details, but be forwarned that it's kinda gruesome.

What I will say is that I will be in the hospital for from two to four weeks depending on how well I heal. Since they will be rearranging parts of my digestive system, I won't be released from the hospital until I can eat without fear of those rearranged parts coming undone. Then I'll be at home for a few weeks and will start chemotherapy at some point. A lot depends on how quickly I recover from the surgery, so those details will come later.

The blog will continue while I'm in hospital because I will be handing over the task of keeping it updated to my People. My one child in particular seemed to be gungho about doing some communicating on my behalf.

To all of you that have taken the time to call or drop me an e-mail, leave a comment, send me a card, send chocolate (thanks especially to JM for OUTSTANDING dark chocolate), send me blankets and shawls to warm my spirits, pray for me or simply think of me, a great big thank you! It can be hard to keep one's spirits up when life throws cancer at you, but every kindness from my friends has made my journey thus far a little easier.

-- Lori

Wednesday, September 24, 2008

And Now For Something Completely Different . . . .

For those of you that haven't seen it yet, I present some footage from my summer vacation that I took with my kid's videocamera. I can't figure out how to embed the link, so you'll have to copy and paste this into your web browser:

http://www.youtube.com/watch?v=_1FKEQnI9Wk

My kid added the titling and uploaded it for me.

Sunday, September 21, 2008

Not much to report . . .

Since I am stuck in waiting mode until Thursday when I see my specialist, I really don't have much to report.

So as a public service, here are the signs of pancreatic cancer. As you can see, the symptoms are very general, and that is why pancreatic cancer often isn't diagnosed until it is too late to be treated. Just as a note, I never experienced jaundice; my liver enzyme levels went way high, but not the bilirubin. Bilirubin is what causes the jaundice, and my bilirubin levels have been normal on every blood test.

Also, a common symptom mentioned is nausea and vomiting. I never had either, I just have a complete lack of appetite and very rarely feel hungry.

Because the symptoms are so very general, people are often diagnosed with other digestive problems before anyone thinks to check the pancreas for cancer.

Pancreatic cancer often is called a "silent" disease because it typically doesn't cause symptoms early on. The cancer may grow and spread for some time before symptoms develop, which may be so vague that they are initially ignored. For these reasons, pancreatic cancer is hard to detect early. In many cases, the cancer has spread outside the pancreas by the time it is found. When symptoms appear, their type and severity depend on the location and size of the tumor.

Common symptoms may include:

- Jaundice — If the tumor blocks the bile duct so bile can't flow into the intestines, jaundice may occur, causing the skin and whites of the eyes to turn yellow, the urine to become dark and the stool to turn clay-colored.

- Pain — As the cancer grows and spreads, pain often develops in the upper abdomen and the back. The pain may increase after a person eats or lies down.

- Weight Loss — Cancer of the pancreas can also cause unintentional weight loss. This is often due to an inadequate intake of calories because of nausea, vomiting and loss of appetite.

- Digestive Problems — Digestive problems may occur if the cancer blocks the pancreatic juices from flowing into the intestines, which help the body break down dietary fats, proteins and carbohydrates. Stools may be different than usual and appear pale, bulky or greasy, float in the toilet, or be particularly foul-smelling.

Tuesday, September 16, 2008

Biopsy Results . . .

I talked to my specialist's office today about my biopsy results and about my climbing liver enzyme levels.

I will be seeing my GP to have my liver enzyme levels checked.

I will be seeing my specialist on September 25th for the biopsy results.

The itch hasn't been too bad today; I noticed that my face just started to get itchy around 3:30 or 4 PM, which is later than I noticed it yesterday.

As for the biopsy results, I myself am certain what the results were, so I'm not bothered about having to wait more than a week.

Monday, September 15, 2008

The Itch is Back . . .

I managed to have a whole week and two days without either taking antihistamines or being incredibly itchy. Lemme tell you what's been happening.

I have been taking Aspirin for the pain and inflammation of my liver since my GP diagnosed it in August. At our specialist appointment on September 4, I thought the doctor told me I had to get off the Aspirin and start taking Tylenol. Makes sense. Aspirin acts as a blood thinner and will make you bleed a lot more if you are cut. Tylenol doesn't do that.

The last Aspirin I took was that Thursday morning; I switched over to Tylenol that afternoon and continued to take it up until last Thursday morning (September 11). Every time the Tylenol wore off, the pain was coming back stronger. At first I just thought it was in my head; then after the biopsy on September 8 I thought it was the effects of having a gastroscope stuck down my throat and a needle poked through the wall of my duodenum. But Tuesday night the pain was very strong, and got worse all day Wednesday.

Wednesday I decided I needed something stronger and the doctor had said I could take Tylenol 1s (codeine - yum!). I bought some. The first dose sure took away the pain, but the pain came back stronger. Before bed I took two more and the pain went away again. About three in the morning, I woke up in near agony. I could FEEL my entire liver because I could feel the pain radiating in and around it, right around my right front, side and back.

It was a terrible night.

I took another two Tyelonel 1s and decided I had to try something different. I decided to call the specialist's office and ask if there was something else I could take for the pain. When I called, the nurse told me it was no problem if I took Aspirin, as long as I stopped five to seven days before the operation.

Okay, so good, back to Aspirin. The Aspirin worked within the hour and took the pain away better than the Tylenol had (or maybe there was some placebo effect working - ya godda believe in the medicine!). Anyway, since Aspirin is an anti-inflammatory, it makes sense it would help relieve liver inflammation. And since TYLENOL has to be metabolized by the liver before the body can use it, it seems to me it might just make an inflamed liver worse.

Anyway, upshot of all this is that the stupid itch has come back, probably because my liver became more inflamed from the Tylenol, and that has driven my liver enzyme levels up again. Even worse, the itch is not bad on my feet this time - it has concentrated on my hands and my FACE!

If you have never had an itchy face (and I mean an itch like a hundred thousand mosquito bites spread over your chin and your cheeks) count your blessings.

Last night I started the antihistamines again. I am hoping to get away with Benadryl at night only, because the itch is certainly not as bad as it was in July.

Still waiting for biopsy results.

Friday, September 12, 2008

The Story So Far . . . .

This story actually goes back a bit, so bear with me.

In June, I had a pretty hectic month: eldest daughter graduated from high school, big retirement and long service party to organize (big job), plus the usual end-of-school-year stuff to deal with. June is a tough month for me and I'm always glad when July rolls around.

My folks came up for daughter's grad, and my mom didn't think I was in ill health at the time, just a little tired and stressed, but that's understandable. And I had lost some weight.

July brought an unusual problem for me: pruritis. Pruritis is a medical term that just means itchy skin and doesn't convey any idea of the itch I experienced. It was so bad I was waking up at night scratching. I wanted to tear my skin off! The worst areas were the soles of my feet and the palms of my hands where it felt at times like I had bugs crawling underneath my skin, a twitchy, creepy-crawly, oh-gawd-when-will-it-stop itch. I was bruised all over from scratching, and once scratched a spot on my foot until it bled.

I also was suffering from a lack of appetite but didn't really realize I wasn't eating and was continuing to lose weight. I just felt miserable all over

The obvious cause of such an itch would be an allergy to something so I tried an antihistamine. It worked but left me in such a mental fog that I was just barely functioning. So I went to the clinic and saw a doctor, got a different kind of antihistamine and some advice about not using scented soaps and laundry sheets and stuff, but there was no change. Except that I was sleeping EVEN LESS because the antihistamine wired me up so tightly.

I made an appointment at the end of July to have a physical with my family doctor, who ran through the whole list of allergy dos and don'ts again, plus a gave me a different regimen of two anithistamines, one for the daytime and one for the night. The odd thing about the itch was that there were no hives and no welts except marks I left when I scratched too hard. The doc also decided to go on a little fishing expedition and ordered a wide battery of blood tests. She didn't seem to concerned with the weight loss.

The new antihistamines made a big difference and masked the itch well PLUS I was able to sleep. Oh, sleep! What a blessing those who sleep easily and well take for granted.

The blood tests were back in a week or so and did turn something up. My liver enzyme levels were way up. Way, way, WAY up. I had hepatitis.

The doctor ordered more bloodwork to see if we could figure out what was causing the hepatitis, with the most likely cause being Hepatitis A. There are other causes, such as the Hep B and C viruses and autoimmune hepatitis.

She also ordered an ultrasound, saying to me that if the bloodwork came back with positive results, we would cancel the appointment.

Two weeks later, the bloodwork came back negative for Hepatitis A, B, and C, and the blood test for autoimmune hepatitis also came back negative a few days later. My liver enzyme levels were dropping but were still very high.

I went to the ultrasound appointment on August 27 and it was quite interesting to me because I had never had one before. The sonographer, however, seemed to concentrate more on the area between my ribs than on the area under my right ribs where the liver is located, which I thought was odd, but what do I know about taking ultrasound pictures of someone's liver? After the ultrasound, the sonographer asked me to stick around so he could show the results to the doctor on duty, then a while later asked if I could stick around for a CT scan. A little red flag went up in the back of my mind.

I had the CT scan. Except for the vast quantities of water I was required to drink, it was not uncomfortable and was an interesting experience, especially the contrast die they injected into me. HOT FLASH! I'm too young for them (ha!), but I'm sure the contrast die gave me a good idea of what they'll feel like.

The little red flag became a great big red flag the next morning when I got a call from my doctor's office asking me to come in that afternoon. I went in knowing they had found something pretty serious, and, expecting the worst, I assumed it was cancer.

Sometimes assumptions are right.

The doctor told me the ultrasound had found a mass on my pancreas consistent with carcinoma, and the CT scan had confirmed it. Pancreatic cancer.

Well, hell.

I was expecting liver cancer. Pancreatic cancer, I knew, was pretty much a death sentence. Low survival rate. Not good.

I don't know I managed to keep my equanimity while I was in my doctor's office, but I somehow managed to get a good grip on myself and kept holding on. While I was sitting in her office, my doctor called the local go-to specialist for this condition and talked to him. He told her he would see me the next week and that I might even be in for surgery the week after (that would have been this week - talk about fast). He also asked for a couple of blood tests so my doc gave me a lab requisition and I went off to get more blood drawn.

A week later, on September 4, 2008, I saw the specialist. The Old Boot and I went to HSC to meet him. I was totally prepared for him to walk in and tell me I had three to six months to live. He didn't.

The growth on my pancreas, he said, most likely is cancer. There is a very small chance it is not. It hasn't metastasized. This is exceptionally good news, because pancreatic cancer is one of those dreadful cancers that lies hidden and silent, giving only vague indications of its presence, until it is too late to remove it. People are often diagnosed with all sorts of other digestive ailments before anyone thinks to check for cancer of the pancreas.

I'm lucky. My cancer leaned against the bile duct to my liver and partially closed it off, causing hepatitis (so I really do have hepatitis). The hepatitis caused the unbearable itch that send me looking for medical help. The ultrasound my doctor ordered to get a better look at my sick liver found the growth. Yippee for me!

So the specialist booked me for a biopsy to see exactly what we're dealing with (Is it cancer? Is it a benign growth? If it's cancer, how aggressive is it and what type is it?). I had the biopsy on Monday, September 8, and I hope to get the results next week. I am also to be scheduled for surgery - a Whipple procedure - in October but won' know the exact date until the last week of September.

Some people might think I'm treating this situation lightly with my "Yippee" a paragraph ago. But honestly, it's how I feel about it because I spent a week thinking that I had six months at the outside to live and feeling unutterably sad and miserable. I started planning my funeral. I wrote my own eulogy. I mourned the fact I wouldn't see my younger daughter graduate next June, would never see my children get married, would never see grandchildren, would never (insert milestone here). Heck, something as inconsequential as not living long enough to see the Winnipeg Symphony Orchestra perform Beethoven's Ninth Symphony next April made me bawl my head off.

I have had a reprieve. The executioner has been told to put his axe away for a while. I have cancer, yes, but I have OPERABLE cancer. It will be a fight but I will survive. I feel confident of that. And I can't help feeling pretty "yippee" about it.

Why a blog

A lot of people have set up blogs in the past little while to communicate easily with family and friends. Although I could set up a website, it's a lot more work; blogging is much easier.

So what is this blog all about? Two weeks ago yesterday, I received a diagnosis of pancreatic carcinoma (cancer) from my family doctor. My husband and I kept this information to ourselves for a week, but in the past seven days, we have been telling people what my situation is.

This blog is a central information center where people can check in and find out how I'm doing.