It's another report: the final analysis of the CT scan performed on February 16. I have put the interesting and salient points in bold:
A small, tiny hypodensity in the liver in segment 5 measuring 5 mm, too small to be characterized, however, the parenchyma of the liver is slightly difficult to study due to an early venous phase. Gallbladder, intrahepetic bile ducts are unremarkable.
I spoke to the PCU (palliative care unit) people on Friday, and the doctor gave me some decent news. They can perform a pain blocking procedure that will hopefully block most of the pain coming from the abdomen. This means fewer opioid-based pain pills, which means less constipation, which cuts the vicious circle somewhat.
I think I also mentioned losing my voice. I have two options. The first involves radiation. The good thing about that is that it may control the local tumours in my neck as well as give me back my voice eventually, but the risk is in soreness and burning, which would make eating far less appealing. I am not especially worried about this, though. The second option is to make a visit with the ENT, or ears-nose-throat people. I don't know much about what they do except that there may be botox applied to my vocal cords. BOTOX.
Certain things don't change, though. I am still very weak. I have had an active week, and it caught up with me today. I was in no pain, but I was on my back all afternoon. During this time I didn't eat enough. When it was time for Sujerin and I to leave to watch Shutter Island (decent flick, BTW), it had been about 4.5 hours since eating. I ate at the theatre and decided on a poutine. Not the best choice, but I wasn't thinking clearly and the choices weren't stellar, either. I was actually close to tears for the guilt and anticipated problems I was going to have. Sure enough, halfway through I had a stomach crisis so severe that I left my seat and slumped on the floor against the wall near the entrance breathing heavily for 20 minutes. This is the type of pain that cannot be controlled by pills; it's major, but brief. I knew it would pass.
I am having problems with my bed as well, and don't know if I can sleep in it. I'll try again now after letting the Boost I just had settle down in about 30 minutes.*
*I know that consuming beverages now isn't the smartest thing, but I have to respond to my body when it says that I need nutrients, no matter when that is.
The Friday before last I paid a visit to the palliative care people (PCU) at the MGH. They put me on the regime I mentioned, and in terms of pain it worked perfectly for three whole days. I haven't felt that great since the summer. Last Monday morning (the 15th), they called and asked about constipation. I still hadn't gone in about a week, so we decided that an enema was in order. 4, actually. That afternoon, I bought them and took the first of what was to be four daily enemas. Within 30 minutes, of course, my vacation from suffering was over, and I was in pain from 3:45 pm to 11 am the next day, just in time for the CT scan that the PCU had scheduled for me to see if there wasn't anything else in the abdomen causing me discomfort.
I felt fine again, because my afternoons are typically good. After the scan I sought out the PCU and they suggested I drink Peg-Lyte every day. I started that evening, and naturally didn't feel great. It became so bad, though, that I didn't sleep that evening. Suj (who I was supposed to have lunch with that day) took me to the hospital at noon Wednesday, and when I mentioned my scan from the previous day, he got me the preliminary results within minutes.
Long story short: on January 28, there were a lot of lymph nodes infected with cancer, but no organs. By February 16, my pancreas had a huge mass in it. 5.6 by 4.2 cm. Not even three weeks. When my oncologist found out about it, he was floored. While this is very bad, but does not change my plans in any significant way. I have to get a second opinion from some other docs at another hospital (which could positively affect my financing for a certain off-label treatment I haven't mentioned here yet).
Everything was fine on Monday. Julie was over. I smoked, and had some appetite, and got tired the way I wanted to. And then I had part of this tea, maybe 2-3 small cups, and decided that something was wrong. Stomach didn't feel right. So I went went to bed, and less than an hour later I was in intense gas pain. I tried to take Tylenol and massage the pain away, avoiding Statex for fear of constipation. It didn't work, so I tried taking a hot bath, relaxing my stomach muscles and hopefully alleviating some of the pain. It actually worked, so I was able to get back to sleep and only wake up once or twice.
But the next day was different. I wasn't feeling especially hot that day either, in fact, I had more gas pain throughout the day. I couldn't go outside, and asked Julie to come back. Tylenol seemed to be working less and less, as did any other solution I could come up with such as pot or hot showers/baths. That night, the pain intensified. The hot bath did nothing. I had Julie buy some Gas-X and Imodium, the latter because I couldn't tell exactly what my problem was. It did feel like diarrhea pain, without the end product. When I took the Gas-X, I ended up puking almost immediately while sitting on the toilet. Same thing when I took the Imodium. Luckily, they were the only two times I puked at all.
Where n is not a nice tiny integer, like 5. No, n is considerably larger than that. Large enough for its exact value to be insignificant. The PET scan that I had on Thursday, January 28 was my NINTH. Yes, I was surprised, too.
Since the previous study, this patient has been treated with chemotherapy with the last dose given apparently on January 15, 2010.
The current study shows multiple intense hypermetabolic foci scattered in the neck with a predominant involvement of the left upper and left lower regions, as well as in the left supraclavicular zones and less obvious hypermetabolic foci in the right upper neck are also noted.
On this first day of 2010, it seems appropriate to first review 2009. Let us begin.
I started the year waiting around for doctors and staff to return from their holidays so that I could get a PET scan scheduled. My chemotherapy had failed, and we were considering other options. This waiting period would last until March, when I finally did 2 weeks of radiation for the first time. I also started acupuncture soon afterwards. Both of these things made me feel physically good for a good number of months.
When I returned to work in April, I had absolutely nothing to do. Any project that I had been working on had be restaffed, and the company had not signed any news contracts this year. (Apparently that wouldn't happen until September.) I basically twiddled my thumbs for 2 months, and pretty much asked for a mutually beneficial release. I got my wish on June 10.
I then spent the next month doing work for the Cedars Cancer Institute, and then I filmed a documentary which I have spoken extensively about.
And part of this year was spent facing death in other young adults with cancer.
I would like to direct you to some pictures of myself I took a few minutes ago. People often say to me that I don't look sick, or that I look pretty good. With all my whining, maybe they expect something more disturbing.
In this picture, you can see the right side of my neck here (left side of the picture). It's normal. There's a straight line down from my jawline.
Not quite the same in this picture. Can you see the large bulge on the left side of my neck (right side of photo)? This isn't even the best angle to really see it; there's a fairly large component coming out of the screen towards you. This is a large series of metastatic tumours in my neck that started in my esophagus. That's cancer you can see. I am so obsessed with these ones that the ones in my abdomen don't even register on my radar.
*sigh* Maybe I should just go back to blogging about race.
Addendum: I should mention that without this latest round of chemo I would be in unimaginable pain and unable to move my neck at all. The tumour size would be much bigger and the pain from not being able to move my neck (moving to my back and elsewhere) could have eventually prevented even walking.
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