Tag Archives: whipple surgery

Thinking outside the box – UPDATE

Thinking outside the box – UPDATE
Fourth of July fun at Z-Farm

The past few weeks have been an emotional roller coaster ride for my family, friends and me. Confirming that the malignant adenocarcinoma had returned to the head of my reconstructed pancreas and having my oncologist tell us without treatment we have just months would send any human being to a deep dark place.

Having survived the absolute most fatal cancer for eight years has truly been a miracle thanks to God, you my prayer warriors, my fantastic medical team of primary care doc, surgeons, radiologists, gastroenterologists, radiologists, oncologists and the PA’s and nurses who assist them at Mayo Clinic in Jacksonville, FL.

But, realistically, we always knew there would be a day when the cancer would take over.

For a time we placed our complete trust in a non-approved trial drug Herceptin Hylecta (trastuzumab and hyaluronidase-ovsk) recently used as immunotherapy treatment for early breast cancer in HER2 positive patients, with great success I might add. Tests were run to determine the DNA of my tumor and provide the best possible match for the gene therapy. The prayer was that I might be the first pancreas cancer patient to receive the treatment…and that it would destroy the cells. That was truly our only hope.

When we asked if surgery could be performed to remove the tumor, the answer was no, there has not been success in the past with patients with similar medical situations. So truly our only hope was in the trial drug. So, we began the infusions.

Entering the chemo suites that familiar smell and feeling rushed over me like a bad dream. But, I knew this treatment would be different. My oncologist told me I would not lose my hair, I would not experience nausea but would possibly have a rash. A rash? I could surely handle that. But, it was just returning to this place I had avoided for two years, that sick feeling returned. I was happy to see a familiar face, a nurse who sat with me the entire infusion watching for adverse reaction but more importantly, chatting in light conversation.

As the test reports came in my case was presented by my oncologist to the Thursday tumor board, a group of up to eighteen Mayo docs from different departments. (Get a second opinion? Why when you have eighteen of the finest doctors in the world collaborating over your MRi’s, scans, blood work and pathology reports.)

One of the surgeons attending that day probably said, “Oh this is Judi, I am familiar with her case. She is the one who defies all of the norms with her PC.” But most importantly, he thought he had a solution. He presented his ideas to the board and they all agreed.

Shortly after the meeting my oncologist phoned. His excitement came right thru the phone as he explained what the surgeon was proposing. He told me surgery was being offered to me and to expect a call from Dr. Stauffer.

When Dr. Stauffer called I listened intently to his plan. He began by stating, “Judi, we need to think outside of the box with you.” He explained they would like to surgically remove the tumor, a suspicious lymph node behind the mesenteric artery as well as a lesion that had shown up for years on my liver, but had not grown in size in any of my scans. He said, if you agree to the surgery, I believe it can work.

My reaction was, “What have I got to lose?” He replied, “You have nothing to lose and life to gain.”

I have received two infusions to date and am scheduled for a third in early August. Scans and tests will be reviewed to check results of the infusions and to be used in the open surgery that will be performed August 17th.

Many of you are praying for me and as you have heard me say in the past, I truly believe this is the explanation I have for my survival. God is listening to your payers, and granting them. For this we are eternally grateful. So, again, I am asking for your prayers for the doctors and nurses on my care team to receive what they need to have a successful surgery. Again, not just for me but to make surgery a possibility for other PC warriors with resectable tumors.

Thankful for all of my prayer warriors and thankful for a surgeon who is willing to think outside the box.

Update…

Update…
This is a spiritual place…Z-Family Farm – Fletcher North Carolina

God has granted me so many miracles throughout my life. But the most miraculous of all has been the gift of eight years since my diagnosis of pancreas cancer on April 29th, 2014.

Tommy and I agree these have been the best eight years of our lives together.

Our faith has grown so enormously and so deeply throughout this journey that we count that as another huge miracle He has blessed us with. Our children experience firsthand the importance of having a relationship with our Lord and Savior Jesus Christ and all agree we could not handle this without Him. We put our trust in Him completely to lead us through this difficult trial.

For our friends, it has been miraculous as well. They pray diligently and many daily that we can have one more day, one more good scan, one more birth, one more memory. They see Him answer those prayers time after time. I know it has deepened their faith as well.

The most recent miracle has been the success of our 6th Champions for Hope event. Thanks to our sponsors, friends and volunteers who open their hearts and their pocketbooks to help us raise EPIC amounts of money to help the disabled community and continue our research at Mayo Jacksonville for pc early detection. Thank you just never seems enough.

Yesterday we received some news. An MRI revealed a suspicious mass in the reconstructed head of my pancreas. The MRI was ordered by my oncology team due to ongoing weight loss and GI issues I have had since last July.

The doctors believe the pancreas cancer has now metastasized to my Whipple operation site. Many of you know I have mets to my lungs that have remained stable since July 2018. (Another miracle.)

They have ordered an Endoscopic Ultrasound Procedure for June 23rd to biopsy the tumor and confirm 100% the adenocarcinoma has returned to this spot. They are not able to perform this biopsy before that date due to my positive Covid test June 1st. This test would require twilight sedation and therefore must follow CDC Covid protocol of waiting 21 days from the positive test date.

My Mayo team respects my decision to forego chemotherapy as a treatment and maintain the best possible quality of life. 

They are seeking a clinical trial drug that might be successful working with my HER2 (Human Epidermal growth factor Receptor 2–positive). No person with pancreas cancer has ever received this treatment. It is approved to treat early-stage breast cancer. When this drug works for me it could mean that other pancreas cancer patients with this HER2 gene could benefit as well.

So, we ask for prayers for another miracle. Not just for me but for the countless other pc patients who may not have access to or doctors who even are aware of this treatment.

Tommy, me, and our entire family will continue to pray we can graciously accept God’s will for the outcome whatever it might be.

But, here is one thing you can completely count on…when the day comes and my life is over…I win. I will be sitting at the feet of Jesus whole once again in heaven for all of eternity.

If you are not a believer, I pray you will accept Jesus as your personal savior and be able to turn your trials into blessings just as we have.

I love you all and I am forever grateful and humbled by your love, support and prayers.

Another miracle?

Another miracle?

The next thought after your doctor shares with you the terrifying news that you have a mass or a tumor your mind goes on defense mode. Or at least that is what happened for me. A defense mechanism seemed to take over. “Surely it is not cancer”. “Can I die?” Maybe you were like me and truly didn’t see this coming. You may never seriously have thought about trying to wrap your mind around those chilling words. You might think it couldn’t happen to me.

It has been four years and four months since my doctor informed me of the mass that had taken residence in the head of my pancreas and slowly over who knows how many years it grew until it was large enough to make it’s presence known. Appointments many specialist, CT scans, blood work, MRI’s, surgeries that lasted nine and a half hours, chemo, radiation, drains, ports, biopsies, more scans and more surgeries, and countless glasses of clear contrast….but, thankfully I am still here and I am feeling very good.

Adenocarcinoma is the deadliest form of pancreas cancer. Unfortunately, pancreas cancer is the one that is clinically and scientifically least understood. In 2018 doctors cannot predict how these cells will act. Yet, the diagnosis of pancreas cancer is up twenty to thirty percent I heard someone say. According to PanCan.org it is scheduled to be the number two cancer killer by 2020 beating out breast cancer for the number three slot in 2017. No longer does the diagnosis appear for the 70 year old smoker typically male. It has joined the other fatal cancers that refuse to discriminate between gender or age or social behavior. What will it take to bring attention to this silent killer that creeps into more and more bodies every day?

Statistics say only nine percent of those diagnosed with pancreas cancer will live five years. Looks like I might make it to April 29th, 2019. But, the cancer is back. This time it has taken residence in my lungs. About eighteen months ago I had one small spot in my lung. Today I have eight. If you count the three that were removed from my left lung late June, that would make eleven. They say I should be able to live at least two more years before the tumors begin to impede my oxygen supply, and I am counting on it.

But, there are options that can POSSIBLY shrink those tumors and most importantly stop more from forming. Chemotherapy could possibly do this for me. But, at what cost? If you read the side effects, they warn of fatigue, loss of appetite, diarrhea, vomiting, rash and/or yellowing of the skin, possible hair loss, weight loss…

I no longer have thoughts of “Maybe it’s not cancer.” Pathology has proven by my DNA it is in fact return of pancreas cancer. But, I do have hope in a drug that targets cells that grow and divide quickly. Unlike surgery or radiation, this drug is so toxic it also attacks healthy cells, like those of the skin, hair, intestines, and bone marrow. But, it is a drug that could give me more precious moments of time. Time with my family and friends. Time to see my new grand babies and those babies of my children’s best friends. The children I have watched grow into adults right before my eyes. Precious time.

When I visited my oncologist after my scan last week he recommended I consider Capecitabine, a chemo drug in pill form taken twice daily. My Joseph asked would I be able to travel on this drug. “Everyone reacts a little differently to it.” doctor said. “I am strong and tolerated chemo quite well last time.” I jumped in. “Only one time did my blood work require half a dose in the entire six months of my treatment.” “Take home the information and think about it.” Dr. Mody said. I responded….”I will be praying about it.”

Sunday morning Tom, his Father and I sat in a tiny wooden pew at St. Patricks Cathedral in NYC. Cardinal Doolan was the celebrant followed by four priests and several alter servers. Fortunately for us it was the service with music. What sounded like a choir of angels sang from the loft at the rear of the church as the huge organ pulsed its deep bass tones.

I was sure of it…I will begin the chemo this week.I have to take a chance this drug will hold those tumors at bay. I need more time, and I am asking God to grant it, another miracle.

Hearing this, Jesus said to Janius, “Don’t be afraid; just believe, and she will be healed.” Luke 8:50/NIV

St. Anthony patron saint of miracles

Treatment….

Treatment….

You are now cancer free”, declared Dr. Asbun with a huge smile on his face. “The surgical team has done our part and now the rest is up to you.”

World Famous Mayo Clinic - Jacksonville, Florida

World Famous Mayo Clinic – Jacksonville, Florida

We truly believe our mind and body work together in the healing process. We also believe our faith plays the most important role of maintaining our positive attitude and hope for total cure. Surgeons can remove the deadly cells but they cannot control the patients mind. Therefore, it is of the utmost importance to surround the patient with positive support and continuous prayer for strength and continued hope.

The conversation usually always gets around to DX with radiation and chemo patients surrounding us. Tom, my Joseph is usually the one by my side in waiting rooms or comfy reclining chemo lounge chairs. When I share my diagnosis of pancreatic cancer or adenocarcinoma to the medically informed, they are not sure what to say next. According to the American Cancer Society, for all stages of pancreatic cancer combined, the one-year relative survival rate is 20%, and the five-year rate is 6%. I happened to be one of the blessed who’s tumors were operable. Whipple Surgery was scheduled within two weeks of my diagnosis.

There is a definitive protocol for PC and as you can well imagine, the timeline is tight. Whipple resection done laparoscopically is a relatively new procedure. (God certainly knew what He was doing when he moved us 15 minutes away from Mayo Clinic 20 years ago, one of the few surgical teams who perform this surgery laparoscopically.) And, recovery is greatly reduced from the more common “stem to stern” incision which requires a much longer hospital stay and extensive healing from the outside as well as the inside.

Whipple was performed on May 12th, 2014. I was discharged just 5 days post surgery. Recovery was going very well and I was able to be closer to our new Grandson, born May 5th, Jude Garrity. You talk about a reason to live! What a wonderful carrot God provided. And, I must not forget to mention all of my family and friends who surrounded me with support, meals, flowers, cards and most importantly prayers from all over the globe! I would go home on a no fat diet and begin chemo therapy treatment in six weeks.

Suddenly, things took a turn for the worst. 8 days later, I was rushed to the Mayo ER with a fever of 100.4. While this doesn’t sound like much of a fever, my body was telling us something was wrong. I was dehydrated and feeling very lethargic. Tests were completed and it was determined I had three areas of abscess in the surgical site. One was very large. I was admitted and placed on four antibiotics and drains were placed to remove the abscess fluids. I remained in the hospital for 11 days. June 5th I was discharged to home health care for 19 days for twice dailyIV antibiotics and close monitoring. My weight continued to plummet. My appetite was non existent and the food tasted nothing like it was supposed to. This was the most difficult time of my illness. However, the antibiotics did their job 30 days later (June 24th, 2014) I was discharged from home health and off antibiotics. Tom and I took a much needed trip to Hilton Head Health where they prepared non fat meals for me and encouraged me to walk and gain my strength.

On July 11th I began my first chemo treatment…Gemcitabine. The schedule, three Fridays for infusion and one Friday off. August 11th, just one month later, I began my Radiation and 5FU therapy. This consisted of 28 radiation treatments performed Monday thru Friday and the placement of a chemo pump which slowly infused 5FU (Fluorouracil)24/7.

Radiation therapy is actually pretty incredible. Each morning I would arrive at Mayo around 8AM and by 8:15 I was changed and laying on the radiation table hands above my head and my chemo pump resting above my hands. Permanent markers were tattooed on my torso where the radiation needed to penetrate. A special “mask” had been made, a mold really, of my torso which would enable the techs to position me in such a way the radiation would reach the organs of my surgical site. I would be placed on the table, the mask over me and locked into the table. Next the techs would leave the room and take an Xray to determine I was in the exact position I needed to be. Sometimes they would reposition the table remotely. Then the Radiation would begin, a large round scope would circle my entire torso twice quite slowly. I never felt anything and pretty much relaxed while I listened to my favorite Pandora station “French Cafe”. The entire process took maybe 15 minutes. Oh and the techs are angels. Some mornings when I was feeling under the weather they would wrap my legs in a warm blanket and make sure I was comfortable.

I opted to have a Bard Power Port inserted just below my collar bone to carry medicine into my bloodstream and to also allow one easy access for blood-draws. The port is placed below the skin and is about the size of a quarter. It is attached to a small catheter which is placed inside one of the central veins that take blood to your heart. When a special needle is put into the ports’ septum, it creates access to your bloodstream.

The port enabled me to carry my chemo pump with me.

Here I am sporting my new Chemo Pump.....

Here I am sporting my new Chemo Pump…..

I was blessed to not have many of the side effects that accompany chemotherapy. While I do live with nausea and fatigue, both are controlled with Creon, Reglan which I take three or four times daily as needed. And I have not had any hair loss! (Thank you Jesus)

At this point, I have one more radiation treatment scheduled for Monday, September 15th, 2014. I will have four weeks off of radiation and chemo to allow the chemo and effects of the radiation to leave my body. On October 15th, I will resume the “Gemzar” chemotherapy protocol of three Friday infusions one Friday off for three months. My last chemo treatment will be Christmas Eve!

I think I will celebrate being cancer and treatment free with a nice glass of Caymus Special Select, my first since April!

God is so good!

The Infection…

The Infection…

“Less than three percent of patients undergoing Whipple surgery contract infection.” said our surgeon, Dr. Asbun.

Just seven days after discharge from a six day Whipple surgery recovery stay, I was rushed to the Mayo ER with a 101 temperature and general overall feeling of lethargy. The drain, placed in my side to remove excess bile that collected post surgery was filling with a different looking substance. I was admitted and a CT Scan was ordered for the morning. The scan revealed three areas of abscess, one quite large where the original drain was located. The surgical team agreed I would need one more JP drain with the hope the third smaller abscess would respond to the massive doses of IV antibiotics I would be given.

Dr. Brumble, Infectious Disease

Dr. Brumble, Infectious Disease

The protocol, determined by my infectious disease doc…Lisa Brumble, began. Serious antibiotics: Caspofungin, Ceftriaxone and Vancomycin were administered intravenously twice daily, Metronidazole (Flagyl) given orally once daily. Daily visits from my surgical team, nutritionist, physical therapists, and infectious disease doctor were glimpses of the seriousness of my condition. I remained hospitalized for 12 days then discharged to a home healthcare agency for 19 more days of twice daily visits to administer the hour long infusions, flush the drains and take my vitals.

To say I was weak would be an understatement. I was recovering from a 9 and 1/2 hour major resection of my digestive system, and now my body was fighting off critical infection. I had no appetite and the antibiotics made the taste of food even worse. My weight was plummeting.

Every night my sweet husband Tom, would sleep in the recliner next to my bed in the hospital. Many times he prayed out loud holding my hand, asking God to bring us through this. His comic relief was always welcome and normally produced a big smile. I wondered if I could love this man any more…and then I did. He encouraged me to eat and walk the hospital halls to give me strength. He was truly my “Joseph”.

Daily visits from our church priest, deacons and nuns could be counted on. Even the Priest from St. Paul’s visited when he could. They administered the sacrament of holy communion, breaking the host into the smallest piece to be sure I didn’t have a problem digesting it. They prayed over me and told me about my CHRP sisters who were always asking and praying for me. They encouraged my faith and assured me I was in God’s hands.

My closest friends visited daily bringing me flowers, rubbing my hands and feet with creams and enticing me with milk shakes and thoughtful non-fat meals that took huge effort to shop for, prepare and deliver. I truly felt God’s love for me in their tender and genuine care for me.

My dear friend Lynda Masulli lovingly prepared and delivered meals that adhered to my strict diet.

My dear friend Lynda Masulli lovingly prepared and delivered meals that adhered to my strict diet.

The final day in the hospital was an especially difficult one for me. It marked the one year anniversary of the death of my sweet friend, JT Townsend. Carmen, JT’s Mother, stayed with me the majority of the day until I was discharged. We talked about her son and what an amazing man he was. She reminded me JT was up in heaven as my intercessor, making certain I got everything I needed. We clung to one another as we recalled our favorite memories.

By June 24th, the antibiotics had done their work and a CT scan and blood work revealed the infections had diminished. I would be taken off the meds and could resume a more normal schedule. Tom had a brilliant idea. He would take me to Hilton Head Health for a ten day get away. The Docs agreed it would be a great RX! And we were off……..

My hero.....Tommy Z aka, JOSEPH

My hero…..Tommy Z aka, JOSEPH

Home at last....

Home at last….

Jude’s Dudes and more…..God’s Love

Jude’s Dudes and more…..God’s Love

The support we have seen from family, friends and even strangers is mind blowing! Sunday before surgery, the Jude’s Dudes group left The Players Championship final round to come to Mayo and show their support. We had 42 Dudes’ show up! Fr. Frank was making his daily visit to my hospital room when everyone showed up. He could not believe it! They wore their shirts on “pink out” day at the tournament to show support for our family. This truly touched our hearts.

Our support group Jude's Dudes....family and friends.

Our support group Jude’s Dudes….family and friends.


More information: http://www.pgatour.com/news/2014/05/11/Outside-the-ropes-players.html
From WWP: Thank you everyone for wearing your purple today to show your support for everyone who has been affected by Pancreatic Cancer. We hope that those who have personally been affected know that they have teammates who truly care and love them. Like Adam Silva, WWP

From WWP:
Thank you everyone for wearing your purple today to show your support for everyone who has been affected by Pancreatic Cancer. We hope that those who have personally been affected know that they have teammates who truly care and love them.
Like
Adam Silva, WWP

WWP Director, Adam Silva stopped by our hospital room a few days post surgery to tell us WWP is showing it’s support by wearing their purple shirts each Friday. They also sent flowers and had a special bracelet made for me with charms for PC, WWP and Hope. Lindsay’s Marketing Team filled a clear jug with pieces of purple and silver paper with prayers and wishes to us as we endure this trial. We love our WWP family.

In October, 2013 I attended a life-changing retreat at our Church…Our Lady Star of the Sea. This weekend is called “Christ Renews His Parish” CHRP for short. We quickly formed a strong bond with the attendees and the sisters who put on the weekend. When they heard about my diagnosis they gathered the day of my surgery after morning mass to pray the rosary. It is wonderful to have a church family.

My Christ Renews His Parish Sisters from the October, 2013 Retreat. These girls

My Christ Renews His Parish Sisters from the October, 2013 Retreat. These girls

My Bible Study group organized a prayer vigil of about 30 girls. They all came together to pray the morning of my surgery. Some of my Bible Study girls have been meeting for over 15 years. I am thankful for each one of them. We pray each other up through every trial and blessing that befalls our sisters. They are Godly women who know the power of prayer. I know when we ask them to pray they are faithful. They are my “prayer warriors” and I love each and every one of them.

Many of my friends told me they lit a candle for me as they visited churches all over the world!

My sweet friend Kelly Winer lights a candle at beautiful Cathedral de San Juan

My sweet friend Kelly Winer lights a candle at beautiful Cathedral de San Juan

Many other friends, business associates and family prayed and asked their prayer warriors to pray as well. I know that God heard those prayers and answered them that day.

Family members dropped by the hospital.

My Grand Nephews, Tate, Isaiah and Mac popped in to visit Aunt Judi

My Grand Nephews, Tate, Isaiah and Mac popped in to visit Aunt Judi

My Grand-daughter Taylor graduated from Ponte Vedra High School while I was recovering in the hospital. I watched the graduation live from my daughter in laws cell phone. After the ceremony, Taylor came to the hospital to get her kiss from her Grandma! I was so happy to see her in her cap and gown and give her that big congratulatory hug and kiss.

Taylor's Graduation surprise

Taylor’s Graduation surprise


Once we came home from the hospital the love continued. Two of my friends planted bright and colorful flowers and huge balloons on the mailbox to greet me when I drove in.

Our family was not accustomed to being on the receiving end of this generosity of giving. Complete meals arrived each day. Through the help of my sweet daughter Lindsay, a “Caring Bridge” site was organized and meals were planned. It was amazing.

God showed me His love for me through each set of hands that prepared a meal, rubbed my feet with lotion, changed our bedsheets and ran the vacuum! All of these tasks done with love by my angel friends. Thank you all!

Monday, May 12th…the surgery

Monday, May 12th…the surgery

psalm-91_1

“Father, I dwell in Your secret place. I say of you that You are my refuge and my fortress, my God, in whom I trust. Surely, You will deliver me from the fowler’s snare and from the deadly pestilence. You will cover me with Your feathers, and under Your wings I will find refuge. Your faithfulness will be my shield and rampart. I will not fear the terror of the night, nor the arrow that flies by day, nor the pestilence that stalks in the darkness, nor the plague that destroys at midday. A thousand may fall at my side, ten thousand at my right hand, but it will not come near me. I will only observe with my eyes and see the punishment of the wicked. As I make the Most High my dwelling – even the LORD, who is my refuge – then no harm will befall me; no disaster, plague, calamity will come near my home for You have given Your angels charge over me to keep, defend and preserve me in all of my ways; they will lift me up in their hands, so that I will not strike my foot against a stone. I will tread upon the lion and the cobra; I will trample the great lion and the serpent. Father, You said that because I love You, You will rescue me; You will protect me, for I acknowledge Your name. I call upon You, and You answer me; You are with me in trouble, You deliver me and honor me. With long life will You satisfy me and show me Your salvation.” Psalm 91

A friend visited me the day before I entered the hospital and shared this powerful Psalm with me. She is a cancer survivor and told me she personally read this comforting Psalm as she battled breast cancer surgery and treatment. I will be forever thankful for this gift.

As they were preparing me for surgery early Monday morning, Tom prayed with me beside my bed. We had both read the Psalm together at home. I told him I would ask God to cover me with His feathers and under His wings I would stay until the surgery was over. He kissed me and I was taken back to the OR.

The surgery lasted 9 and 1/2 hours. While I do not know what it was like to sit in the waiting room or even all of the family and friends who sat there in support of my immediate family, I am so very thankful for each and every one of them.

As I was coming out of the anesthesia, I felt as if I were wrapped in some sort of cocoon. I could not see immediately, but I asked aloud, “Am I in heaven?” Tom replied..”No, you are right here with me!” My answer…..”PRAISE GOD!” as I extended my hand to the Lord.

It seemed a short time before our surgical team surrounded my bed. “We have great news”. Said Dr. Asbun. “You are the reason I do what I do.” “You made the correct decision to proceed with surgery. We have removed the cancer and you are at this moment….cancer free.” ” I have done my part…now the next step is up to you.”

God had been faithful…He had heard the prayers offered on my behalf. God is my refuge and my comfort and my protector, just as He promises.

He is YOURS too!

The surgical consult….

The surgical consult….

The week before surgery was surreal. Our new little “Jude” came home from the hospital, The 2014 Players Championship was literally being held in our backyard, my Father in law – Lugi was visiting as he always did for the tournament and of course for the birth of his fifth Great-Grandchild, and our neighbors and friends were curious to see the completed backyard renovation that had caused the dumpster and porta-potty to be displayed in our front yard since October 2013. Add to that the sudden announcement that I had a very serious diagnosis..people were curious.

The effects of the cancer were beginning to zap my energy. I began to jaundice. The rapid 20 pound weight loss was clearly evident. I wanted to make this last week before surgery a celebration. Late in the week the surgeon had scheduled the placement of a JP drain to relieve me of some of the bile that was blocked from the bile duct and streaming into my system causing the jaundice, the itching and scratching. But by the weekend, I developed a fever and late Saturday night we made a trip to Mayo’s ER. I was very weak and nauseated. They decided to admit me and keep me on an IV until the surgery Monday. In retrospect, this was the best decision as I doubt I would have been strong enough for surgery without the fluids. I needed to build my strength for the huge surgery that lied ahead.

Dr. Horacio Asbun, my hero!

Dr. Horacio Asbun, my hero!


Thursday we had a pre-op visit with the surgical team. My team and several other surgeons had been meeting to discuss my case. They had read over 1500 images from my MRI and were diligently planning their attack on the tumor and surrounding cells. Some of the lymph nodes were lit up in the pancreas and kidneys. They would remove any suspect lymph nodes during surgery. All of the tumor and surrounding tissue would be removed until the margins surrounding the tissues showed cancer free. The tumor in the pancreas head measured roughly 3.5cm. They were confident the Whipple surgery would be a success. They also informed us of the most dangerous effects the surgery could have on me; excessive loss of blood requiring transfusion, infection, etc.etc. We left the appointment prepared to take the next and most important step in our battle against this demon.

Shortly after we left the hospital, we received a phone call asking us to return to the hospital. The surgical team wanted to discuss something further.

When we arrived they told us one of the surgeons had viewed an image from the MRI that showed something disturbing. Part of the tumor appeared attached to the biliary artery. Removal of the tumor would be very risky. Dr. Asbun said he had an obligation to tell us about this find and to offer some options. One would be to undergo adjunct chemo therapy to possibly reduce the size of the tumor. This would of course delay the surgery and really did not have any guarantees. If he went ahead with surgery he could excise the tumor and place a stint in the artery replacing the effected section. It was difficult, but he assured me he was not afraid and he could do it.

He told me I was the only one who could make the decision. Tom and I looked at each other, another punch in the gut. But, we had our faith. We were going to make it thru this. We were going to be one of the 20 percent that the cancer did not return. We believed this and we had prayer warriors who believed this too. I felt God was telling me to proceed, to remove the cancer from my body. I asked Dr. Asbun what he would do if I were his sister. He told me he would go with the surgery now. That was what I felt too. “Let’s get the cancer out as soon as possible.” I said. We were on for Monday.

Unknown

Whipple surgery is basically the removal of the portion of the pancreas effected by the tumor,(in my case, the head of the pancreas), the gall bladder and the small intestine. The diagram illustrates the resections.Since my cancer was located in the head only, I would not be required to live on insulin. I am blessed to have a surgeon who performs this procedure laparoscopically. Normally an incision would begin below the breastbone and down the entire stomach. Recovery for my surgery would be much more speedy than open surgery. I was confident I was in good hands. Plus, I had an army of friends, bible study Sisters-In-Christ, CHRP Sisters from our church and family who were praying for me constantly. God would surely hear those prayers and I knew He would bring me through.

The Diagnosis…..

The Diagnosis…..

Tomm & Judi at Kylies WEddingTom was seated on the sofa as I sat perched on the paper-covered table. The 30 something, very sweet, Sports Medicine Doctor shared my report displayed on the large computer screen. “There is a mass in your pancreas,” she said very cautiously not wanting our eyes to meet. Tom leapt from the sofa to my side on the table as we both tried to absorb the words. My first reaction…”Can you live without a pancreas?, recalling Pancreatic Cancer to be the most deadly form of cancer. “Yes, you can today, with the proper medication.” She continued to relay the medical facts that had been compiled in the short 24 hours since I had met with her. She read the blood test results showing elevated pancreatic enzymes, “…..Lipase, Serum 661, desired level should be between 7 and 60.” “I have scheduled an appointment for tomorrow with a general surgeon who specializes in this area,” she said. We clung in disbelief holding each other as the doctor wept with us. We prayed to God on the way home that He would give us the strength to weather this storm. We gathered our immediate family and told them everything we knew.

I loved to work out. Well, I longed to be in shape. Menopause and gravity had added about 30 pounds to my medium frame over the years. It seemed like each decade added 10 pounds. So, this kept me walking in the mornings, biking and being active. When my best friend’s daughter was planning her wedding we even went to a personal trainer. However, the impact on my 60 year old bones was too much. I began to suffer extreme knee pain. After a visit to an orthopedic surgeon he recommended he repair a meniscal tear. The surgery was performed January 15th. He kept me off my knee for 6 weeks. Once the knee was healed he released me to normal physical activities. Excited to be back in the gym, the pain returned. I was popping 800 mg ibuprofen twice a day to control the pain. Never having taken any type of pain control, I was reluctant to continue, but the pain was significant. I had read the side effects and wondered about the effect on my liver and kidneys. A few months later I stopped the meds.

The pain continued and I felt sick to my stomach most of the time. I suppressed the urge to throw up. All of a sudden I noticed I had lost weight without really trying. I was avoiding eating and when I did eat it was a small portion. I couldn’t even drink wine! Something must be wrong.

One day I noticed my urine seemed extremely dark. I had started to itch. My body was covered with small red scabs where I had scratched my skin raw. In my mind I felt it was related to the medications and the nausea was caused by the pain. It was time to go to the doctor to find out was was going on.

Mayo Clinic, Jacksonville is located 15 minutes from our home. A dear friend suggested I make an appointment at the Primary Care facility. Mayo is approved by our insurance and they certainly have a wonderful reputation. Monday morning I called for an appointment. After explaining my symptoms, the nurse suggested I see the sports medicine doctor and she happened to be available that afternoon. God was once again behind all of this!

When I arrived for the appointment I explained everything to the doctor. She decided to have blood work and a stool and urine sample. I was escorted into the lab where the samples were drawn. The next morning the nurse called to tell me I needed to come in for a sonogram that afternoon. What could be happening?

As the tech lathered my stomach with gel and guided the probe while watching the monitor intently, I noticed her focusing on one area. She was marking the spot with a red arrow drawing a line from one end to the other. A measurement? I asked her what that was. She began to probe different areas and showed me my kidneys, liver and pancreas. I asked her about the arrows. She said the Radiologist would review the scan and report to my doctor the results. I knew that would be her canned response, but I wanted her to say something more definitive. I sensed something was not right.

We were very familiar with this disease. When Tom and I first met, he lived with his aunt and uncle directly across the street from me. Shortly after we were married, Frank was diagnosed with pancreatic cancer. He was 36 when he died just 18 months after receiving the report. We had read the statistics and knew what we were facing.

The next few days were a flurry of consults with the surgical team, blood tests, CT scans and MRIs. The doctors held nothing back. While they shared the worst case scenario, they also encouraged us with the positives. I had no previous serious medical issues. They marveled how at 64 I was not on any prescription medications. With the exception of exercise related problems with knees and ankles, I was in very good physical condition.

We quickly realized God had provided the perfect medical team at a world renowned hospital. Our Mayo Clinic surgeon, Dr. Horatio Asbun, specializes in pancreatic surgery. He is the best in the country. His team was equally impressive. He would perform whipple surgery laparoscopically, removing my small intestine, gallbladder and the head of my pancreas where the tumor had taken hold. He told me he could do his job and remove the tumor from my pancreas. And, he believed I had the ability to do my part. He said I had a strong faith in God and a positive attitude.That was 90% of what was needed to make the surgery successful. We were all a team and we would don our armor and enter this battle together. Most importantly, he asked his surgical team to pray for me between the meeting and the surgery date. We were confident God had placed us in good hands.

We are blessed with a strong faith in God. Tom and I knew we would get thru this and there was a reason why this was happening. Tom began to attend morning mass daily. I attended with him and we advised our Church family about the diagnosis. They immediately called to action. Fr. Frank administered the anointing of the sick. We could face the outcome no matter what it was.My CHRP Sisters and my Bible Study group organized prayer vigils for the surgery date. Our amazingly close family would also use their faith to pull through and we would do it together.