CancerCompass message board discussion started by 0ldog on 2/23/2008 http://www.cancercompass.com/message-board/message/all,21247,0.htm Thu, 20 Nov 2008 00:00:00 GMT Thu, 20 Nov 2008 00:00:00 GMT http://backend.userland.com/rss RSS.NET: http://www.rssdotnet.com/ Quite a while ago I posted some questions about digestive problems with Whipple survivors. Now I have some answers that may help others, but first a little history.In 2001 my wife Kathy was diagnosed with pancreatic cancer and a Whipple was performed in Strong Memorial in Rochester NY. Over the past 3 or 4 years her weight has steadily dropped going from 170 to 105 at the start of our cruise.While on vacation in the Caribbean Kathy had a hypoglycemic reaction, found out later that her sugar had dropped to thirty (yes 30). We had just left St. Maarten and when I tried to wake her up from a nap she acted goofy. I gave her some sugar but when it didn't seem to help I called 911 and they came within five minutes with the crash cart. The ran some tests along with an EKG. From her vitals they thought she may have been having a heart attack, they even turned the ship around and headed back to St. Maarten. She was rushed to the local hospital by ambulance and by the time she got there the sugar she had been given on the ship had started to kick in and she became coherent. She ended up staying over night in the hospital, then another day on the island before we flew to Antigua to catch up with the ship. There were no more sugar scares during the rest of the seven days, but she had her same vomiting problems that surfaced after the Whipple. This time though she was getting sick after every meal, she ended up loosing ten pounds on the cruise (problem was I found it). We got back home Feb. 8th and made an appointment with her primary care doctor for the next Monday. Her doctor re-did some of the tests along with a set of labs and scheduled an appointment with a cardiologist. Tuesday morning, the 12th, we got a call from the lab tech. telling us that her doctor wanted us to go directly to the emergency room. Kathy's potassium had become dangerously low because of the lack of nutrition for two weeks. Of course the ER ran all the tests again along with numerous others. Bottom line was they confirmed the low potassium and started IVs for that and the lack of food. Their attention then turned to some other things that they had found. A CAT scan showed spots in the liver and a mass in the upper intestine. (This hospital was where they first detected the mass on the pancreas in 2001 but the operation was done in Rochester. Also the oncologists were new to the case because her regular guy was in Geneva, but on vacation. Previous scans that she had along with her medical records were scattered between 4 or 5 hospitals, complicating the case.) The Emergency Room doctor said "With her past history the mass was probably cancer and that it had metastasized to the liver" the tone in which she said it was like "bend over and kiss your ass good bye" Well that's how we felt anyway, it was like getting kicked in the gut. When our heads cleared we remembered that previous scans over the years had shown spots in the liver. Kathy's regular oncologist had followed them over the years and determined they were just fatty deposits and nothing to be concerned about. The mass could very well be scar tissue that we were also aware of before. They did a Gastrointestinal Endoscopy to see about the obstruction, but didn't find anything inside the digestive system. The mass was outside the stomach wall pressing on it to cause the blockage. Next they wanted to do a biopsy of the liver to see about the spots. They wanted to do that first then if it was cancer they probably wouldn't bother with the stomach surgery. With Kathy's blood counts she's no longed a candidate for chemo or radiation if it is cancer. Some of the invasive stuff took longer to schedule because of a platelet shortage in the northeast and only emergency procedures are to be performed. They surgeon had gotten the medical information from Strong (Dr's. notes but no pictures, x-rays scans etc.) and the oncologist in Geneva (Dr. Rubins) and there is no mention of spots in the liver hence forth they are assuming they are new. They got a shipment of platelets Monday, performed the liver biopsy and it was negative and they could proceed in solving the digestion problem. They wanted to do an MRI but they couldn't because of an issue with the dye. Seems like her kidney function was so low that they are afraid that she wouldn't be able to get rid of the dye from her system. This would have given them a better idea of what the blockage was. Wednesday the 20th the surgeon told us that yesterday they planned on going in Laparoscopically to do another liver biopsy (the oncologists still didn't believe the spots were benign) and look at the mass. If the liver was still clear and the mass was, indeed scar tissue they would then open her up and attempt to remove it. Because of Kathy's past history of digestive problems most of her doctors over the years figure that the muscles that move food through the digestive tract were damaged during the invasive Whipple. Because of that the plan of attack was to remove what scar tissue they could and bypass that spot with a section of her intestine. If the muscles were working properly then that would probably have solved the problem. However to make sure no matter what happens she will have the best possible quality of life they are installing a G tube and a J tube. If need be she can use the G to remove stomach contents instead of vomiting and the J to infuse nutrition into the lower intestine for nutrition. If just the removal of the obstruction solves the problem then these tubes can be removed right in the doctors office. (At least that's what I'm told) I left her last night groggy but knowing the operation went well. She has a morphine drip for pain and recovery could take anywhere from 5 to 10 days depending on progress.For all facing the fight against cancer there is hope, even the second time.John 0ldog Sat, 23 Feb 2008 00:00:00 GMT <>John,  Thank you so much for your story and I am praying fora fast recovery for your wife.   I do know the fear and theproblems after the Whipple and you went through so much just to getsome stability for your dear wife. Your wife is lucky to have you as acaregiver.  I am not a candidate for the Whipple but I do haveepisodeds of low blood sugar quite often.  Your story about howyour wife had one in the Caribbean on a cruise ship sure bought backmemories of this January when I had a low sugar occurance.  As forme my husband and I reconized it and dealt with it untill the sugarclicked in.   Please post to let us know how she is doing.  <>Take care,Janice <> Infoquest Sat, 23 Feb 2008 00:00:00 GMT