Biopsy My sweetie and I get to the hospital by 9:15 for the 9:30 appointment, and sign in.  Eventually they take both of us back, get me into a gown, and take my vitals.  They verify that I know my name, my age, and why I’m there.  This has all been arranged by Dr. B in a rush, and they’re fitting us into the schedule.  We wait.

My sweetie will leave when I go for the procedure, as he can’t be with me then anyhow and he has a bunch of errands to run.  The nurse comes to draw blood.  My poor vein has been subjected to a lot of activity over the last several days and doesn’t want to let her in.  She finds another nurse who’s very good at that, and she is able to do the insertion without any trouble.

More time passes before the surgeon (Dr. F) arrives, apologizing for the delay.  I wave a kiss to my sweetie, and they wheel me into the room. You know the drill now as well as I do:  breathe in, breathe out, don’t breathe; breathe normally.  Dr. F says it’s important to do it the same way each time, so they know what the rhythm will be.  They will take a specimen and the pathologist will tell them if it’s adequate; if not, they’ll have to go back.  It’s a needle probe, so the wound is very small.

They get their specimen; it’s sufficient.  I’m rolled back onto the stretcher and taken upstairs.  My sweetie returns after about forty minutes, just before one o’clock.  I’ve had juice and cookies by then, and he brings me one of those nutritional supplement drinks, and I have that.  I still have my book.  I am there, they tell me, for four hours.

After two and a half hours my butt is sore from the hard stretcher.  My book is mercifully engrossing, but I’ve been doing a lot of reading and I’m bored.  They’re checking my vital signs every fifteen minutes at first, then every half hour.  No chance I could be moved to a chair; “bed rest” is required.  One of the volunteers recognizes my book and we have a chat about the series and some other books we’ve both read.  That helps.

At three o’clock one of the doctors comes along, has a look at me and checks me out.  Then a nurse, examining the incision (that other nurses and the doctors have been checking regularly) decides that it’s swollen and I can’t leave yet.  Fortunately, someone intervenes.

I accompany the locker mistress down the hall to get my clothing.  My wristband appears quite clearly to be marked “M2″, but that locker contains someone else’s clothing.  (I knew it was wrong because it was on the wrong side of the corridor, but “M2″ it was.)  More waiting while they checked;  “N2″.  And there were my things, and I changed, and we walked out of the unit and the hospital, and went home.

Tuesday I will talk to Dr. B.  I still have told nobody except my parents and a single friend.   At the evening phone call, my mother says she “said something” to my sister’s husband, leaving it up to him whether or not to tell my sister.  I have to talk to my brother in the morning.

With all the medical appointments I’ve been having, my colleagues at
work could tell that something was happening. I decided there was
nothing to be gained by reserving the information, and my boss certainly
needed to know, so I filled them in. A couple of people telecommute; I
didn’t tell them immediately.

I still have the biopsy scheduled for tomorrow, but I’m pretty sure I
know what the results will show.

In the office, I weed through a couple of decades of not-yet-discarded
files, disposing of those that are no longer needed, and putting aside
for shredding anything with personal information.

Tomorrow is the biopsy, and then I’ll begin to talk to my family.

I am not surprised at the call from Dr. B:  The results of the CAT scan are in, and I should come down to the office.  This, of course, is shorthand for uh-oh.  My sweetie (also a patient of Dr. B) comes with me to Dr. B’s office.

There is a mass at the tail of the pancreas. It’s not localized (i.e. surgery is impossible).  It has spread to the lining of the abdomen and to the liver (in more than one place).  (Aha:  that’s the pain under my ribs.)
  
Dr. B has already arranged for me to have a scan-guided biopsy (of the liver, because the pancreas is so hard to reach). He draws blood and examines me to clear me for a biopsy in two days (allowing time to get the results of the lab work), and gives me an oncologist referral. The doctor looks stunned; I’m still in great shape (but I’ve lost more weight). (Of course, I haven’t had breakfast or lunch two days this week.)  And I won’t be able to eat before the biopsy, either.

He wants me to schedule an apointment with an oncologist (Dr. S) at the end of next week, when the path report will be in, and to call him (Dr. B) on Tuesday for the preliminary path report.

I tell my parents (who are calling every evening) and that one friend.

My brother’s sweetheart died in 2008 of pancreatic cancer. Of all the people I don’t want to have report this to, he’s top of my list. I speak to him every week, and will tell him in the usual call. I am so dreading this.

My parents want to know what I’ll say to my sister and my brother. I say I’ll tell them Saturday, during our usual family phone calls. They think I shouldn’t wait. I am in no hurry to spread this news.

CAT scan  They tell me to allow three hours, but it doesn’t take that long.  Nothing by mouth after midnight– again.  This is almost enough to make me hungry.  It’s done at an imaging center in the Columbus Circle area.  I drink two jars of a barium contrast medium, and they go down surprisingly easily after the fast.  I wait about forty-five minutes for the stuff to make its way to my gut, and then they take me inside to put on a gown and go into the room.

First thing they do is an intravenous with a second contrast medium (iodine based). This will show up the internal organs; the barium is for the gut.  I point which vein is easier to tap, which makes the technician happy.  My arm is up; they wheel me forward until I can brace it against the frame of the machine.

It’s a lot like the ultrasound:  breathe in, breathe out, don’t breathe; breathe normally.  They’re really good about including the “breathe normally” part, for which I am grateful.  The procedure doesn’t take very long; I’m out in a little over two hours.

I go home and eat something, but not too much or I won’t be able to eat any dinner at all.

Ultrasound.  Nothing by mouth six hours before, but I get up early enough that I can have my normal breakfast.

The procedure isn’t particularly unpleasant:  breathe in, breathe out, don’t breathe; breathe normally.  The tech leaves and says that if they need more information a supervisor and/or a doctor will come back with her.  The supervisor comes back.  She’s not as reliable at including the “breathe normally” step, and I have good breath capacity, so sometimes she’s ready for the next picture while I’m still holding from the last one.

But clearly they’re after something.  We go through the whole process (tech, then tech and supervisor) again.  Finally they decide that’s all they can get and let me go.

Dr. B calls later that day to say that they saw something near my pancreas.  The pancreas is hard to get on ultrasound, so I should have a CAT scan, which I’m able to have done the following day.  (Nothing to eat after midnight, though, and this one isn’t until 2pm.)  We have all begun to worry.

I tell my parents (who asked me to give them the results) and one friend.  Nobody else.

September 7   I see Dr. B reporting my vague symptoms. It looks to him like residual effects of a virus, tells me to take a probiotic, to avoid caffeine, citrus, and dairy, and report back in a week.  I’ve already exchanged my morning oatmeal for toast with marmalade.  I exchange the marmalade for apricot jam and skip the coffee and my usual orange juice.

September 14  I call Dr. B.  The discomfort isn’t gone, but it’s noticeably less and less persistent.  He offers to send me to a G-I specialist, but we agree to keep on with this regimen as long as it seems to be helping.

September 21-30  I am much better most days.  I’m not really happy, but I have my annual physical scheduled in a couple of weeks and I am noticeably peppier than I was just a couple of weeks ago.  I’m eating less than I used to because trying to eat a normal sized meal makes me very uncomfortable.  (I mentioned this to Dr. B when I spoke to him.  It’s the aspect that bothers me the most.)  Of course this is having a beneficial effect on my figure, but it’s not the way I’d have chosen to lose weight.

October 8-10  The partial fast on Yom Kippur (I have medications to take) is far too easy, but it seems to help.  I have no gut rumblings at all.  I feel better than I’ve felt in weeks.

October 11  At some time during the morning, I’m aware of an annoying tenderness under my right ribs, like a stitch in my side but it’s not going away.  Physical in two days.

October 13 Annual physical.  I’m in great shape.  Blood pressure, heart, kidney and liver function, everything is terrific.  I’m up to date on colonoscopy, mammagram, bone density, etc.  Dr. B is happy.  But, you know, there’s been that long discomfort and now the tenderness; let’s do an ultrasound.  I  am able to schedule the ultrasound for October 17.