He received great care while at huntsville hospital. But sure is glad to be well enough to go home!
Tuesday, December 31, 2013
Tuesday December 31
He is being released from the hospital, feeling ok. The spleen pain started back last night and is bothersome today.
Monday, December 30, 2013
Monday December 30
The endoscopy went well. Doesn't look like the vericies shrank as expected. But not currently bleeding. So they will try to manage the bleeding with oral medication. Still hoping to go home tomorrow.
He is tired and ready be finished with the poking and prodding!
Monday December 30
The endoscopy went well. Doesn't look like the vericies shrank as expected. But not currently bleeding. So they will try to manage the bleeding with oral medication. Still hoping to go home tomorrow.
He is tired and ready be finished with the poking and prodding!
Monday December 30
Jays endoscopy is scheduled for 10 am. He is having a little pain but manageable. He had a chest x-ray last night. He's been having a little cough. He's still in good spirits but ready to get out of the hospital.
Sunday, December 29, 2013
Sunday Dec 29
Having a good day today. I've walked the halls, had two good full meals, and just feel good. Tommorow I will be rescoped to see if the GI bleed is fixed. Hopefully I will be home by New Years!
Saturday, December 28, 2013
December 28
Jay didn't have a good night or day. Pain from the spleen embolization set in during the night. It was difficult to get under control. He is on a morphing pump which makes him have nausea and hot flashes, but is necessary due to the intensity of the pain. The doctor said it will take a few days for the pain to subside. Hopefully tonight will be a better night.
BTW...He let me shave him last night...I went with a new look!
Saturday 28 Dec
I'm having a rough day today. As 40% of my spleen dies off the pain has increased. Pain meds have been effective but cause nasua and sweating. Hopefully tommorow will be a better day!
Friday, December 27, 2013
December 27
Jay had a really good day today. A little abdominal pain late this afternoon, but manageable. He will resume a regular diet tomorrow. The next endoscopy is scheduled for Monday. Hopefully the spleen embolization was successful and the GI bleed is resolved. Guess we will find out Monday.
Thursday, December 26, 2013
The first three weeks
On December 5th, after about 10 days of abdominal pain, thinking he had a gall stone, Jay went to his family practice doctor. The doctor sent him to the ER for an abdominal CT to determine if the cause of the pain was due to an appendicitis or gall bladder issues.
The abdominal CT showed a mass on his pancreas, spots on his liver and inclusions to the splenic vein. This was beyond anything we had ever imaged.
Friday December 13, the second liver biopsy was performed. Prior to the procedure he was given Demerol to which he had an adverse reaction. The procedure was delayed a couple of hours to allow him to get over the nausea, and for his blood pressure to stabilize. The procedure was successful in retrieving the needed tissue. He was released after observation.
Saturday December 14, we celebrated the twins 3rd birthday with a party for their friends.
Sunday December 15, we took the twins to the Chattanooga aquarium!
Monday December 16, Jay waited at home for a potential pancreatic biopsy if needed. Fortunately he did not have to undergo another biopsy.
Tuesday December 17th, Jay went to the hospital to have his chest port installed. This allows for chemotherapy without having to constantly start IVs.
He then went to the cancer center where he received his chemo schedule.
We are fortunately to have the best oncologist, who is very passionate about his work and the care of his patients. He was able to consult the chair of surgical oncology at Vanderbilt ... On Christmas day!
Wednesday December 25, Jay was still at the hospital. His mother was spending the day with him. I was home with the babies trying to provide them with as much normalcy as possible. I received a text from Jays brother saying that after additional consultation, all the physician involved thought it best to perform an embolization of some of the blood flow to the spleen. The procedure was to take place the next day.
The abdominal CT showed a mass on his pancreas, spots on his liver and inclusions to the splenic vein. This was beyond anything we had ever imaged.
Jay was perfectly healthy and had no medical issues. He had some indigestion and pain in his right upper chest/shoulder area. But this was a very new development, which was increasing in intensity each day, but at no point did we think it was anything more serious than a potential gallbladder attack.
After the abdominal CT Jay was admitted to hospital for pain management, dehydration and to schedule a liver biopsy.
Friday December 6th the liver biopsy was performed with little pain and no complications. Jay was released later that afternoon.
Over the weekend the abdominal pain continued. Jay was no longer able to lay down on his back or sides, he was resigned to sleeping in a recliner. He was able to manage the pain and was on a bland diet, no fat, no red meats. This was to help reduce the inflammation in the pancreas.
Monday December 9th the biopsy results indicated "fatty liver", which gave us hope that the mass on the pancreas was a lymphoma.
Tuesday December 10th, he received a call to schedule a PET scan.
Wednesday December 11th, Jay had the PET scan and blood work.
Thursday December 12th, Jay met with the oncologist who confirmed the diagnosis of pancreatic carcinoma. The initial liver biopsy was inconclusive because the spots on the liver are peas sized and not easily accessed or retrieved. A second liver biopsy was scheduled for Friday December 13th, using a radiological intervention that would allow for a better retrieval of tissue.
A chemotherapy appoint was scheduled for Tuesday December 17th as well as the installation of a chest port allowing for chemotherapy.
After the abdominal CT Jay was admitted to hospital for pain management, dehydration and to schedule a liver biopsy.
Friday December 6th the liver biopsy was performed with little pain and no complications. Jay was released later that afternoon.
Over the weekend the abdominal pain continued. Jay was no longer able to lay down on his back or sides, he was resigned to sleeping in a recliner. He was able to manage the pain and was on a bland diet, no fat, no red meats. This was to help reduce the inflammation in the pancreas.
Monday December 9th the biopsy results indicated "fatty liver", which gave us hope that the mass on the pancreas was a lymphoma.
Tuesday December 10th, he received a call to schedule a PET scan.
Wednesday December 11th, Jay had the PET scan and blood work.
Thursday December 12th, Jay met with the oncologist who confirmed the diagnosis of pancreatic carcinoma. The initial liver biopsy was inconclusive because the spots on the liver are peas sized and not easily accessed or retrieved. A second liver biopsy was scheduled for Friday December 13th, using a radiological intervention that would allow for a better retrieval of tissue.
A chemotherapy appoint was scheduled for Tuesday December 17th as well as the installation of a chest port allowing for chemotherapy.
DIAGNOSIS: Stage IV pancreatic cancer, with metastasis to the liver and vein inclusion. Adenocarcinoma is the type, tumor marker CA19-9 was elevated to 202,000.
Friday December 13, the second liver biopsy was performed. Prior to the procedure he was given Demerol to which he had an adverse reaction. The procedure was delayed a couple of hours to allow him to get over the nausea, and for his blood pressure to stabilize. The procedure was successful in retrieving the needed tissue. He was released after observation.
Saturday December 14, we celebrated the twins 3rd birthday with a party for their friends.
Sunday December 15, we took the twins to the Chattanooga aquarium!
Monday December 16, Jay waited at home for a potential pancreatic biopsy if needed. Fortunately he did not have to undergo another biopsy.
Tuesday December 17th, Jay went to the hospital to have his chest port installed. This allows for chemotherapy without having to constantly start IVs.
He then went to the cancer center where he received his chemo schedule.
Schedule:
Tuesdays 5 hours of chemo followed by 24 hrs of at home chemo
Wednesday brief check up at cancer center and receive another bag of chemo for at home therapy
Thursday brief check up and then disconnected from the at home chemo pump.
This will take place every other week for 8 weeks. The oncologist will then order more blood work and an abdominal CT.
Tuesday December 17, the first day of chemo was pretty easy. Unfortunately that night around midnight Jay started experiencing a lot of nausea. It took almost 24 hours and three anti-nausea medication to get the nausea under control.
Wednesday December 18, when he went to the cancer center to exchange his bag of chemo they decided to give him fluids to help with the nausea and hopefully provide some relief. He then went home with the chemo and within an hour started battling nausea again
Thursday December 19th, the nausea was manageable, but Jay was still weak and fatiguing easily. The hope was to see a drastic improvement once they disconnected the chemo pump and administer fluids to help flush his system. He left the cancer center feeling a little better. But the nausea returned later that evening.
Friday December 20th, Jay went to the cancer center to receive fluids. Hopefully as the chemo is flushed from his system he will start to recover and have a good "off week".
Saturday December 21, he was feeling better with little nausea. Our daughter was diagnosed with strep throat so Jay went to his mothers to stay isolated from any illnesses. He remained at his moms until Monday morning.
Thursday December 19th, the nausea was manageable, but Jay was still weak and fatiguing easily. The hope was to see a drastic improvement once they disconnected the chemo pump and administer fluids to help flush his system. He left the cancer center feeling a little better. But the nausea returned later that evening.
Friday December 20th, Jay went to the cancer center to receive fluids. Hopefully as the chemo is flushed from his system he will start to recover and have a good "off week".
Saturday December 21, he was feeling better with little nausea. Our daughter was diagnosed with strep throat so Jay went to his mothers to stay isolated from any illnesses. He remained at his moms until Monday morning.
After taking the kids to daycare, I called Jay. He was terribly weak, dizzy and nauseous. We decided it was best to take him back to the cancer center. His oncologist said to bring him in immediately.
Monday December 23rd, the oncologist determined based on blood work that Jays red count was low probably due to a gastrointestinal bleed, such as an ulcer, which is common with chemotherapy. The oncologist order two units of blood to be administered, and prescribed medications to help coat the stomach and reduce stomach acid. While receiving the blood transfusion, I asked Jay to take one of the stomach pills in hopes of feeding him lunch. One of the pills caught in his throat and he began to vomit, old blood, which confirmed the GI bleed. Once everything settle down the oncologist determined that Jay was stable enough to go home with IV nutrients and no food until he returned to the cancer center on Thursday. The plan was to allow the GI tract to rest and the meds to reduce the acid allowing the ulcer to heal. AND allowing Jay to be at home for Christmas with the kiddos!
We went home, received training on the use of the TPN pump from the home health organization and settled in for what we thought was a low key, yet hungry Christmas. Around 11:30 that night Jay started to complain of stomach pains, feeling terrible, and nausea. 12:45 he began to vomit bright red blood. Within a few minutes of the vomiting subsiding we were in the car en route to the ER. He was seen by a doctor very quickly. BTW we had also a taken a picture of the bloody vomit, which saved him an exam to determine bleeding!
He was admitted to a room and they began the process of ordering an endoscopy.
Tuesday December 24th, after a fairly difficult night Jay was able to rest for a few hours before the endoscopy. The endoscopy showed large vericies in his stomach which were the result of the pancreatic tumor pressing on or encompassing the splenic vein. Fortunately the bleed had stopped.
Monday December 23rd, the oncologist determined based on blood work that Jays red count was low probably due to a gastrointestinal bleed, such as an ulcer, which is common with chemotherapy. The oncologist order two units of blood to be administered, and prescribed medications to help coat the stomach and reduce stomach acid. While receiving the blood transfusion, I asked Jay to take one of the stomach pills in hopes of feeding him lunch. One of the pills caught in his throat and he began to vomit, old blood, which confirmed the GI bleed. Once everything settle down the oncologist determined that Jay was stable enough to go home with IV nutrients and no food until he returned to the cancer center on Thursday. The plan was to allow the GI tract to rest and the meds to reduce the acid allowing the ulcer to heal. AND allowing Jay to be at home for Christmas with the kiddos!
We went home, received training on the use of the TPN pump from the home health organization and settled in for what we thought was a low key, yet hungry Christmas. Around 11:30 that night Jay started to complain of stomach pains, feeling terrible, and nausea. 12:45 he began to vomit bright red blood. Within a few minutes of the vomiting subsiding we were in the car en route to the ER. He was seen by a doctor very quickly. BTW we had also a taken a picture of the bloody vomit, which saved him an exam to determine bleeding!
He was admitted to a room and they began the process of ordering an endoscopy.
Tuesday December 24th, after a fairly difficult night Jay was able to rest for a few hours before the endoscopy. The endoscopy showed large vericies in his stomach which were the result of the pancreatic tumor pressing on or encompassing the splenic vein. Fortunately the bleed had stopped.
The blockage in the vein caused a back up of blood into and enlargement of the spleen.Basically the backed-up blood released into the stomach through these vericies (enlarged veins) in the stomach... Like a pressure valve. This is not common and not easily resolved. The immediate action was to give beta blockers to reduce the pressure in he veins. This would keep the vericies from bleeding. But this was a temporary solution.
After a lot of consultation, the oncologist, radiologist, and trauma surgeon decided that the initial path forward was to try the beta blockers both intravenously and orally, with the oral therapy being a potential at home option.
Jay is on liquid diet.
SIDE NOTE: Jay is able to lay flat on his back and roll from side to side during sleep with no pain. The oncologist thinks this is a very positive sign that Jay is responding to the chemo. And if he can get over this hurdle he will able able to resume chemo and see forward progress in disease management.
We are fortunately to have the best oncologist, who is very passionate about his work and the care of his patients. He was able to consult the chair of surgical oncology at Vanderbilt ... On Christmas day!
Wednesday December 25, Jay was still at the hospital. His mother was spending the day with him. I was home with the babies trying to provide them with as much normalcy as possible. I received a text from Jays brother saying that after additional consultation, all the physician involved thought it best to perform an embolization of some of the blood flow to the spleen. The procedure was to take place the next day.
SIDE NOTE: Jays brother is an interventional radiologist. He has been invaluable during this. His guidance and ability to explain and discuss these procedures has made this situations a lot more bearable. We thank him profoundly!
Thursday December 26, after a restful night in the hospital, the embolization was schedule for 9 am. The procedure would be performed by an interventional radiologist. The goal is to close off 35-40% of the blood flow to the spleen resulting in "less blood in less blood out". This procedure will kill 35-40% of the spleen, which can be painful. Jay is prepared and looking forward to getting past this hurdle and back on the path to treating the cancer.
Thursday December 26, after a restful night in the hospital, the embolization was schedule for 9 am. The procedure would be performed by an interventional radiologist. The goal is to close off 35-40% of the blood flow to the spleen resulting in "less blood in less blood out". This procedure will kill 35-40% of the spleen, which can be painful. Jay is prepared and looking forward to getting past this hurdle and back on the path to treating the cancer.
The procedure went well, they feel they successfully closed off the appropriate percentage of the blood flow, Jay recovered very well from the procedure. He is still on a liquid diet.
He returned to his room and was feeling really good. He had a few visitors from work and was having no apparent problems.
Around 5:30 he started to feeling sick and began vomiting. He thought it was due to the morphine pump and not being able to eat. He was still very sick until 745-8pm. He finally saw some relief from the nausea until they started another bag of antibiotics. He was able to more easily get the nausea under control. He ate puddings to help his stomach.
He had a little pain and discomfort during the night.
Friday December 27, Jay woke with mild abdominal pain but wanted to wait until he was able to eat breakfast before he took any pain medication. Hopefully the yogurt will help settle his stomach.
The oncologist came in to check on Jay and deliver "much needed good news"
He had order CA19-9 blood work. The one week of chemo resulted in the tumor markers decreasing from 202,000 to 98,795!
As long as Jay recovers from the spleen procedure he should be able to resume chemo the first week of January.
NOW I am going to set up this blog app on Jays phone so he can update everyone on what is going on.
I'm sorry this initial post is so long, but we've had a lot to happen in the first three weeks.
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