New lab and MRI results from Group Health have been sent to Dr. Back at Seattle Cancer Care Alliance (SCCA) and to Dr. Pommier the surgeon from Oregon Health Sciences University (OHSU). Some of the labs are highly elevated above normal. The MRI showed some growth in tumors left behind in the liver. I'm not sure how to interpret the labs and tumor growth at this point. I will need to have the results interpreted for me by Dr. Feldman, Dr. Back and Dr. Pommier.
I met with Dr. Back last week prior to the results. He thought I was doing well given that the liver surgery recovery is much longer than I had anticipated, taking most people a year to fully recover and the for the liver to fully regenerate. When I do too much I still feel pain, discomfort and soreness. I have symptoms of the tumors and side effects of the drug, Octreotide given every 28 days in the form of a muscular injection that is quite painful itself. I felt these symptoms and side effects were worsening in the last 2 months which is partially why I asked for additional labs and an MRI. My wonderful general practitioner - family doctor, Dr. Shaul, ordered them for me. He also consoled me by telling me he too would be worried in my situation. I felt so better with his listening and discussing every aspect of my fears with me. It worried me that I had not had any scans since March 2013. Usually I would have some type of imaging or scans every 6 months. After the second surgery coming up on November 8th, I will have a concrete plan with a baseline for measuring, that will list frequency and types of scans and labs. There will be an Octreotide scan annually at least and a CT Scan 6 months after that probably with labs every 3 months. Two Saturdays back I went to the P-NET support group which meets quarterly. This was only my second meeting but I learned several new things including the plan I listed above that most people are on for scans and labs. What Dr. Back observed was that my feeling worse coincided with my increased work load at CDSA. For 2 months after the June 28th liver and gall bladder surgery I didn't work much at all. In September I began increasing my work load as we prepared for the ED search and hiring process. Through out September and October I worked in excess of the 8 hours allowed by disability and called the rest volunteering. Unfortunately, the stress of it took a toll on my diet and exercise, yoga and meditation schedule for well being. I pretty much stopped my plan to get ready for the November 8th surgery, all together. For the remaining almost 2 weeks I should be able to eat more veggies and fruit, drink more water and get more exercise, as my work load at CDSA drops back off. With the new ED selected I have focused on some orientation and training time.
Dr. Back gently reminded me that at the end of August he reiterated that I should not be working. He also said I still have had an excellent recovery from the liver surgery and that he feels very good about my being in good shape for the next one overall. Due in part to being both told to eat anything I wanted from the doctors and not exercising I have gained 10 pounds in the last 5 months. The good news is that I won't have to worry if I loose weight during and after this surgery which is expected. This next surgery is to remove several parts of the pancreas. The primary cancer, causing metastases to the liver, bones, thyroid and possibly other places, was found to be located in the tip of the tail of the pancreas during the last surgery. Removal of the primary increases the survival rate. I recently also found out that I may not need to have the thyroid out. Another biopsy will be needed to determine that and they will try to do it while I'm under anesthesia during surgery. The left iliac crest (hip area) where the bone metastases is continues to have increased pain.
On Monday I have an appointment with Dr. Feldman who has returned to Group Health Oncology following a leave for 3 months due to his wife dying of Ovarian cancer. He will be able to give his opinion on the MRI and labs. Later in the week I will try to get an opinion from SCCA and OHSU doctors.
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