On the way to the appointment around 7:30 am I had a low blood sugar, hypoglycemic episode in the car. As soon as I felt the symptoms of sweating, shaking, feeling dizzy and blurred vision Peter got off of I-5 and stopped by a 7-11. We got bananas, crackers and juice. Although I had a yogurt (organic, low sugar from PCC) with fruit just before we left home and was still eating it in the car, I didn't have my usual 2 eggs for protein. Sometimes it is hard to remember all the symptoms and side effects of the tumors themselves and of PNET and of Octreotide; when paying so much attention to the pain medication and symptoms of healing and repairing my body from surgery. I still don't really know why it happened and I didn't bring my blood testing kit with me that morning so I was unable to confirm the low blood sugar numbers. Luckily we were near my moms house in Olympia and we were able to stop by and get the blood sugar regulated. Just being with her, sipping tea and being wrapped in her blankets and pillows seemed to cure me. After 30 minutes we were able to get back on the road to the appointment after thinking we might have to miss it because I did not feel I could make it to Portland in the car feeling like I was going to faint. I brought 3 of moms pillows and a blanket with me in the car even though I had my own pillows from home. She and dad also provided us with 2 "to go" cups; coffee for Peter and Green Tea for me. I have officially completely moved from coffee to tea after being so known for my love of coffee. I'm still using stevia and love the drops they sell at PCC. We were only a few minutes late for the appointment time. It was good thing we left so early. A big thanks to Peter and mom and dad for being there with me through the attack. It is scary and I didn't know whether to call 911 or drive to the hospital. I hate that feeling. I slept most of the way to Portland from there and felt fine by the time we arrived for the appointment.
Dr. Young (who is young) started off the appointment answering the page of questions I brought. Below are a few of the questions. He was one of the team of 3 that I saw every morning at 6:30 in the hospital. After discussing the questions and examining me he began removing the staples and stitches. He had to pull on a few which hurt a bit because they had started growing into the healing skin. The questions:
1. How much time generally does the liver take to recover and regenerate? What else can I do? He confirmed that the level of activity I described as being up much of the day but resting periodically was good. Every one's recovery time varies. It takes around 3 months for the liver to heal. I am doing really well, there is nothing else I can do but eat, rest, take the medication and relax.
2. What prep can I do, if any for the pancreas surgery? Describe surgery? We scheduled the surgery for Nov 1. Pommier will remove the tip of the tail of the pancreas, tissue and lymph nodes he saw that were involved and the spleen. I will need to have 3 vaccines before the surgery and will need to have boosters after the surgery because we are removing the spleen which typically handles certain dangerous diseases. There is nothing I can do to prepare except be healthy, recover and relax.
3. Is SAA LAR 30 injection every 28 days keeping growth and spread from occurring now (Oct 2012 - present) or is this worsening metastases? MRI and CT in spring showed no growth. Octreotide scan reported growth. We believe the injections have stopped tumor growth and the primary from metastasizing. Therefor we could wait a month to do the surgery and it shouldn't matter. I might be ready in October but the Pommier team is very busy in October and I want to help with my daughter Jessica's delivery. Her due date is October 15th so I hope I get to be there for the birth and to help out the first few weeks before surgery. I may change the surgery to Nov 8th just to the give the baby girl another week to be late if she so decides.
4. Do you pick new small tumors in liver to monitor now? Frequency of monitoring; labs and MRI (every 3 months) Yes, after the next surgery we will set a new base line of tumors in the liver and begin to monitor them every 3 months with labs, MRI, CT's and other possible tools.
5. Did bone and thyroid metastases occur sometime before we began Octreotide in 10/12? Did it come from primary in pancreas? Do you think there is more cancer that I need to worry about elsewhere in my body? Yes, we think since we began Octreotide in October we have stopped all growth. Metastasizes came from the pancreas. It is best to focus in the next 2 surgeries and let LAR 30 continue to work. New water based forms of it are being developed that will be able to be injected with a smaller needle.
6. Is there lymph node involvement? Did you or will you remove any? Yes, we removed some last time and will need to remove more this time.
7. Is there reason to assume or believe I will have a “crisis” in the pancreas surgery like I did in the liver debulking surgery? The team will be prepared with Sandostatin and Octreotide drip. The anesthesiologists will be present and informed. There is no way of knowing if there will be a repeat of the crisis in my body.
8. Should we check the fluids in my system now chest/lungs? They listened to my lungs and they were clear; I have no signs of or symptoms of pneumonia. The additional fluids are still present in my abdomen but should be slowly reducing along with inflammation.
Before we left for home we took cookies and treats to the RN's on my recovery floor. None of the ones that we knew were present but we left a nice card too. I'm very happy with my surgical team and the RN's at OHSU.
Our trip home was uneventful but we were able to stop in Vancouver and have crab with my parents and our old friend Dottie over looking the Columbia. They were on their way to Newport Oregon for a little get away. The drive in the car was tiring and I noticed the pain was up that evening. It was to be expected and in the days that have followed I've tried to rest. I've still got lots of energy, especially in the morning and can get carried away with activities. :-)
Jessica (my beautiful pregnant daughter) has been stopping by most afternoons on her way home from the UW. I've had some CDSA contact and all is well there. I've begun to try to taper off the narcotic pain meds but it may be a little too early for that. My body is letting me know when to rest and what to do all I have to do is listen.
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