CT scan obtained for attenuation correction and localization purposes. images generated from the base of the skull to the proximal thighs.The patient is S/P gastric pull-up surgery for esophageal carcinoma.
There is an intensely hypermetabolic 1.7 cm focus with an SUV of 11.7 nestled between the pancreas and the clips anterior to the abdominal aorta, inferior to the origin of the celiac axis, indicating a new metastatic lesion. There is also a more poorly defined focus superior to the origin of the celiac axis at the surgical clips at frame 110 with a maximal SUV of 4.4. It is uncertain whether this latter focus represents neoplastic disease or possibly only inflammatory changes.
Within the mediastinum however, there is also a new 1.6 cm intense lesion with a maximal SUV of 9.7. This node, in the right prevascular space anterior to the SVC at frame 73, would also represent distal neoplastic spread.
Elsewhere, there are no other FDG avid lesions to indicate additional potential sites of hypermetabolic neoplasm. Specifically, the lungs, liver and bones are free of FDG avid lesions.
IMPRESSION:
Mediastinal hypermetabolic metastasis. Additional metastatic lesion inferior to the origin of the celiac axis. Inflammatory or neoplastic changes more superiorly as detailed above.
Recently in Post hospital recovery Category
I have my PET scan on January 31 at 1:30. MGH, D5129.
I really hope that there is a positive result.
I feel something strange where the tumour was. I shouldn't feel anything there. It could be reflux or something, but I dunno. I need January 31 to come quickly.
This was what I received in the mail today, along with my second to last payment from insurance. If I understand correctly, I don't get any long-term disability (and I only wanted a partial amount until the middle of January) because I started treatment during my first three months on the job. This also means that I will have to start back full time two weeks earlier, because I need the money. Luckily for me, my company gives us a paid (I think) shut down from December 24 to January 1.
The obvious lessons: insurance companies are sneaky, and don't get sick during your probation period. This means you.
I forgot to mention: three months ago today my life changed. At this time, I was waking up in my hospital room from surgery. The three month mark is where you can expect to start eating normally, and I am happy to report that I have been doing so for more than three weeks now.
The weekend before last I was up north in the beautiful autumn Laurentides at Camp Kinkora, with the Young Adults Cancer Group, a division of CanSupport. As luck (good? bad?) would have it, I was the only man there. There were two coordinators, one "MC" and five other participants.
So I took a cab downtown last Saturday to meet with these people who I had never met before save one, by chance. I was feeling, as usual lately, pretty crappy, but I was determined to make it there. My motivation was that I really, really needed to talk to some people that are in a similar struggle for health and mental/emotional well-being.
I am depressed, you see. I am not the same person you met in June, full of hope and great expectations. Sure, I still expect to be better, but the feeling isn't quite as strong. But in June I could not have imagined how difficult this recovery would be, and now the reality is brutal. This depression is affecting how I function in my relationship in a major way, but that's a whole other discussion. This is supposed to be a positive entry.
Well, it's been a while since I have said anything. A few things have happened since I last blogged. One, I went to a retreat for cancer patients and survivors last weekend where I ended up being the only guy. Two, I since have pretty much lost my voice to a very bad cough caused by something that has to do with the operation. But last things last. Last night I was in more pain than I have ever been in my life.
As you know, I am supposed to be eating small portions about six times a day. But sometimes when you eat and it causes pain, you shy away from food. I think it's normal, even though it isn't good. This is what happened yesterday morning when I decided to eat some Quaker oats (apple and cinnamon). As a rule, I have this with milk and not water, but since milk and I haven't been getting along that well, I decided to use half milk and half water as some sort of compromise. We're talking half a CUP of milk. I might as well have had a litre. It was painful, but not that bad. I lay down for an hour or so, and then I was fine. But I didn't eat again until 9 pm.
This picture was taken last night around 8:30 pm (Click to enlarge. Warning: popup.) You can try to describe how I look in this picture. No matter what you describe, I'm sure it won't include words like "happy" or "healthy". In fact, I am neither in this picture. I am miserable these days, and this morning I figured out more precisely why. I am 173.5 pounds. I am not been this light since high school; not even my last year, but maybe my second-to-last year. (By the way, does anyone reading this have any familiarity with OACs, or Grade 13? 80s and 90s young Ontario, represent!)
As I type this, I feel nauseous. I really feel in danger of vomiting. I am trying to eat two packets of Quaker Oats. It's good, a little too sweet, though. I've eaten half of it so far. It doesn't look as though it will get finished, as much as I want to finish it. I feel weak and a little dizzy. I really need to keep this food down, not just because I need the nutrients, but because puking is very very bad for someone with innards like mine.
This morning I woke up at 5 am with major back pain. You see, I cannot lie all the way down because the bile and stomach acid will travel to places where they shouldn't. I don't have a valve to prevent this anymore, you see. I need lots and lots of pillows propping me up. I can't lie on my sides, either, because I am still sore. I actually did try to lie all the way down, which resulted in severe, groaning pain for several long minutes. Bad idea jeans.
Last Tuesday:
Since then I have gained about six pounds. I am coming back. By the way, these should be considered "before" pics. Give me a year and we'll see what I can do.
Feel like hell today. That is all. For the moment.
UPDATE: I have uploaded more photos from the hospital stay. Check them out here.
Actually, I've been back at home since late Thursday afternoon, but a problem with the Internet has prevented me from being online until now.
It is hard to express how much I appreciate how all of you have been during my hospital stay (which was harder than the pictures would suggest), but I will try.
Rose: I left you in charge in communications and I must say, that's one of the better decisions I have made lately. I won't forget how you deftly managed the email list and the blog during those ten days, and how you kept everyone in the loop.
But far more importantly, you kept my head above water. On those days and nights where I wasn't sure how I was going to make it to the next (with my mind intact, at least). You provided the right touch when I needed it, you said the right things, you encouraged me and loved me. Everything you did and continue to do had a love element to it that you don't find just anywhere. I hope that I can have half the strength you did when you face a similar hardship. I couldn't have done this without you.
