My Latest Visit with Dr. Cutie . . .

Any day you get to talk to a cute doctor is a good day, and yesterday was even better because we also had a cute intern to talk to as well!

Somebody at the Administration Offices told me to keep my eyes open for cute interns while I was in the hospital. I didn't see a single one. Lots of cute male nurses (I had one night nurse that was hubba-hubba cute and SMART - he really helped me with some problems I was having in hospital) but no interns. Well, a couple of the women were pretty, but I don't swing that way.

But yesterday we had Intern Handsome review my case with us before we saw Dr. Cutie. I found it a little unnerving. I was sitting there thinking to myself "This is one nice looking young fella." Then the word YOUNG became the operative word. He was young enough to be my son! I wondered if he had a girlfriend because he and my daughter would make a very attractive couple!

Anyway, on to the results of the MRI. Basically, the MRI was a baseline so that down the road, the docs can compare the size of the tumor before chemotherapy with the size after some treatments. So there wasn't a whole lot to talk about regarding the MRI. We did get one thing clarified. We had thought there was a cancerous tumor on my liver as well. There wasn't. When my surgeon spoke of biopsying a cancerous spot on the liver, it was actually just near the liver, not on it. I do have a couple of cysts on the liver but they aren't cancerous, and my liver is clear. Yay!

I asked the docs if I could have a picture of Charlene. That threw Dr. Cutie for a bit of a loop, but he promised me to get me a printout of one of the MRI pictures. It's probably not a request they get very often. I think I might have it framed. Maybe I'll hang it on a dartboard and use it for practice. I just wanna see the b**** so I can focus some hate at her.

Dr. Cutie had said at the last appointment that he would be presenting my case to his colleagues, so we asked how that had gone. Apparently, my case incited quite a discussion! Because my case is unusual, i.e., I am very young to have pancreatic cancer, I have always been pretty healthy, I don't have the usual risk factors, there was a lot of talk about what sort of treatment I should have. One upshot of the discussion is that the CancerCare docs are going to formulate a protocol for pancreatic cancer treatment. They currently don't have a protocol in Manitoba. Across Canada, treatment varies depending on where you are. Some provinces treat with chemotherapy and radiation together, others just stick with chemotherapy. In the US, chemo and radiation are almost always used together. Here in Manitoba, it has been the practice to treat just with chemotherapy.

However, Dr. Cutie suggested that in my case, because I am young and healthy otherwise, chemotherapy and radiation together were an option for me. I was quite surprised since I knew that chemotherapy along with radiation therapy is not standard practice in this province, and because it hasn't been proven to be more effective than chemotherapy alone. There haven't been any really good randomized studies done, so it's kind of unproven. We decided that it would be wise to investigate a bit, so Dr. Cutie had us see the radiation oncologist that he works with. Enter Dr. Xray and his intern!

Dr. Xray's intern went over the procedure for radiation therapy with us, checked me over, and had me sign the permission forms. This doesn't mean I'm having radiation, it just means they can get the paperwork and other preparatory things started. Radiation therapy will involve five weeks of daily radiation doses, and the side effects will likely be digestive upset, some sunburn-like skin irritation, maybe some weakness and fatique. I would start the chemotherapy and complete the first round of eight weeks, then the radiation and chemotherapy would be done together for five weeks, then I would be on chemotherapy only after that.

I haven't entirely made up my mind yet, but I am certainly leaning toward having the radiation therapy. Gotta do some research and thinking before I decide. It would sure give Charlene a run for her money, though!

The other thing I had to discuss with Dr. Cutie was pain control. As the incision heals and the nerves knit themselves back together, I am in progressively more pain. I usually start my day feeling good and almost painless, then the pain increases through the day and my bedtime, I'm pretty bad off. Last Sunday night was the worst - I just couldn't get comfortable and was in such pain that I woke up three or four times during the night whimpering. I usually don't whimper! It ain't my style! But the pain was pretty intense.

I had a few Percocets left from before surgery, so for the last few nights I have been taking one before bedtime. They take the pain away almost completely, and they send me off to slumberland. I was a bit concerned that the doctors wouldn't want to prescribe me anything as strong as Percocet, but I was wrong!!!! Dr. Cutie had absolutely no problem with prescribing me more, and suggested that I keep a pain diary by recording the pain on a 0 to 10 scale throughout the day, recording when I take a Percocet, what the effect is and any unwanted side effects, etc. He also said if the Percocets were not sufficient they would look at giving me Oxycontin, a formulation with the same medication as Percocet (oxycodone), but in a time-release pill.

So here I am at home with my bottle of Percocets waiting to hear when my chemotherapy will begin, and considering the radiation therapy. Oh, I also have to figure out what to feed my people for supper tonight. Gee, sounds like I am gonna have an interesting day!

Have yourself a great weekend!

-- Lori