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.

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.

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.