E. has an appointment scheduled at MD Anderson in Texas on Thursday, June 11th.
It is anticipated that after the initial new patient appointment, E. will be referred for lab work and additional tests the following day. He will possibly then have a follow-up appointment on Monday, June 15th. (The Gastrointestinal Cancer Clinic is only open on Mondays and Thursdays.)
Not knowing exactly how the process works, it was difficult to make travel plans, but as it stands right now, we are flying to Houston on Wednesday, June 10th and returning on Tuesday, June 16th. Since the boys are still in school, there are various shifts covering the home front . . . once again, we are so thankful for all our family and friends.
From now until the 10th, we are compiling the many many things that we need to hand carry to MD Anderson . . . ACTUAL diagnostic films such as CT scans, ultrasounds, MRIs and E-rays (CDs or floppy disks cannot be substituted) . . . ACTUAL pathology slides . . . physicians' notes . . . all medications in the orignal, labeled bottles . . . and the list goes on. Needless to say, we'll be making several trips to various offices. I have no doubt that we'll be getting the run-around more than once.
As a side note, E.'s been feeling pretty good these last few weeks (other than a nagging cough and persistant fatigue), so feel free to ask him out on a date. He's quite a catch, if I do say so myself.
S.
Sunday, May 31, 2009
Test Results
I'm one of those people who likes to get bad news out of the way. When asked, "Want the good news or the bad news?" it is always the bad news first. With that in mind, here it is . . .
Bad news:
The bad news is that the celiac lymph node biopsies tested positive and confirmed "continued metastatic esophageal cancer." Because the cancer is still in the lymph nodes, E. is still considered Stage IV.
Good news:
* The initial endoscopic ultrasound found multiple (greater than 10) periesophageal lymph nodes and multiple (greater than 7) celiac axis lymph nodes. According to Dr. C.'s verbal report, only 4 lymph nodes were observed in his lastest endoscopic ultrasound.
* The initial chest CT scan showed a severe thickening of E.'s esophagus. It also showed paraesophageal, gastrohepatic ligament and periportal lymphadenopathy (which means swollen or enlarged lymph nodes in various regions). The lastest chest CT scan demonstrated that the thickening of the esophagus and the adenopathy of the upper abdomen are no longer apparent. That means they couldn't see the original tumor (initially sized at 3.07 X 1.28 cm) OR the many lymph nodes (some initially sized over 1 X 1 cm). The CT scan was "unremarkable." (We've learned that "unremarkable" is in fact REMARKABLE, at least to us. It essentially means "looks normal!")
And to make the news even better, there's more . . .
Great news:
* The PET scan was also "unremarkable." (Did you hear that??? Unremarkable!!!) So, while the biopsies of those lymph nodes was positive, the cancer was not a large enough amount to even be registered by the PET scan.
Although a little disappointed with the continued lymph node involvement and the continued Stage IV diagnosis, miracles are happening. E. clearly responded favorably to treatment and we are anxious to meet with the folks at MD Anderson to see where we can go from here. Your continued prayers and positive vibes are very much appreciated.
S.
Bad news:
The bad news is that the celiac lymph node biopsies tested positive and confirmed "continued metastatic esophageal cancer." Because the cancer is still in the lymph nodes, E. is still considered Stage IV.
Good news:
* The initial endoscopic ultrasound found multiple (greater than 10) periesophageal lymph nodes and multiple (greater than 7) celiac axis lymph nodes. According to Dr. C.'s verbal report, only 4 lymph nodes were observed in his lastest endoscopic ultrasound.
* The initial chest CT scan showed a severe thickening of E.'s esophagus. It also showed paraesophageal, gastrohepatic ligament and periportal lymphadenopathy (which means swollen or enlarged lymph nodes in various regions). The lastest chest CT scan demonstrated that the thickening of the esophagus and the adenopathy of the upper abdomen are no longer apparent. That means they couldn't see the original tumor (initially sized at 3.07 X 1.28 cm) OR the many lymph nodes (some initially sized over 1 X 1 cm). The CT scan was "unremarkable." (We've learned that "unremarkable" is in fact REMARKABLE, at least to us. It essentially means "looks normal!")
And to make the news even better, there's more . . .
Great news:
* The PET scan was also "unremarkable." (Did you hear that??? Unremarkable!!!) So, while the biopsies of those lymph nodes was positive, the cancer was not a large enough amount to even be registered by the PET scan.
Although a little disappointed with the continued lymph node involvement and the continued Stage IV diagnosis, miracles are happening. E. clearly responded favorably to treatment and we are anxious to meet with the folks at MD Anderson to see where we can go from here. Your continued prayers and positive vibes are very much appreciated.
S.
Tuesday, May 26, 2009
Friday, May 22, 2009
PET and EUS done
E. got his PET scan done yesterday. Barely. Because of cancer, chemotherapy, radiation, stress, life, etc., his blood sugars have been all out of whack and running high. Had he been one point higher, he wouldn't have been able to have the PET done. Though it took awhile, the actual PET was pretty uneventful.
Very frustrating is the fact that while the results should be available in 48 hours, we're headed into a three-day weekend and the first available appointment with his oncologist is June 4th. Yes, JUNE 4TH!!! I called and talked to several people, pleading our case. How is it possible that after a major test like this, you have to wait TWO WEEKS to get the results? That just seems ridiculous to me. In the end and in desperation, I begged for at least a phone consult. Heck, an e-mail would work at this point. We'll see if anything comes through. I did go ahead and call his radiation oncologist to see if she could squeeze us in any sooner. So, if nothing else, we'll meet with her on May 28th to hopefully go over the results.
EDITED TO ADD: E.'s oncologist left me a voice message late this afternoon indicating that he had already received the results from the PET scan. He stated that it looked like E. responded to treatment and that no areas "lit up."
Today, E. had his follow-up Endoscopic Ultrasound. The doctor who performed his first EUS did this one as well. Best case scenario would be that the tumor was gone, all lymph nodes looked healthy and there was no evidence of disease . . . probably unrealistic to even hope for short of a miracle. Worst case scenario would be that the tumor had grown, that more lymph nodes were affected and that the cancer had metastasized to other organs.
We learned that E. has in fact responded well to treatment. The tumor has shrunk some (how much we're not sure of yet). And instead of 10 lymph nodes being involved, it appears only 4 lymph nodes are involved now. Because lymph nodes are still involved, E. is still diagnosed with Stage 4 Esophageal Cancer. BUT . . . if the biopsy of the lymph nodes comes back negative, E. will be re-staged to Stage 3. In that case, the doctor said he would be a surgical candidate. (Now remember, local doctors and those doctors we spoke with at UCDavis all follow the philosophy that Stage 4 patients are inoperable. Other doctors at other facilities don't necessarily follow that same philosophy.) Unfortunately, the biopsy results won't be back for about a week.
We're feeling positive about the progress. While not GREAT news, it certainly wasn't bad news. In the whole scope of things, we consider it good news.
And here's hoping for more good news, or even great news, in the weeks to come!
Very frustrating is the fact that while the results should be available in 48 hours, we're headed into a three-day weekend and the first available appointment with his oncologist is June 4th. Yes, JUNE 4TH!!! I called and talked to several people, pleading our case. How is it possible that after a major test like this, you have to wait TWO WEEKS to get the results? That just seems ridiculous to me. In the end and in desperation, I begged for at least a phone consult. Heck, an e-mail would work at this point. We'll see if anything comes through. I did go ahead and call his radiation oncologist to see if she could squeeze us in any sooner. So, if nothing else, we'll meet with her on May 28th to hopefully go over the results.
EDITED TO ADD: E.'s oncologist left me a voice message late this afternoon indicating that he had already received the results from the PET scan. He stated that it looked like E. responded to treatment and that no areas "lit up."
Today, E. had his follow-up Endoscopic Ultrasound. The doctor who performed his first EUS did this one as well. Best case scenario would be that the tumor was gone, all lymph nodes looked healthy and there was no evidence of disease . . . probably unrealistic to even hope for short of a miracle. Worst case scenario would be that the tumor had grown, that more lymph nodes were affected and that the cancer had metastasized to other organs.
We learned that E. has in fact responded well to treatment. The tumor has shrunk some (how much we're not sure of yet). And instead of 10 lymph nodes being involved, it appears only 4 lymph nodes are involved now. Because lymph nodes are still involved, E. is still diagnosed with Stage 4 Esophageal Cancer. BUT . . . if the biopsy of the lymph nodes comes back negative, E. will be re-staged to Stage 3. In that case, the doctor said he would be a surgical candidate. (Now remember, local doctors and those doctors we spoke with at UCDavis all follow the philosophy that Stage 4 patients are inoperable. Other doctors at other facilities don't necessarily follow that same philosophy.) Unfortunately, the biopsy results won't be back for about a week.
We're feeling positive about the progress. While not GREAT news, it certainly wasn't bad news. In the whole scope of things, we consider it good news.
And here's hoping for more good news, or even great news, in the weeks to come!
Saturday, May 16, 2009
Decisions about future plans . . .
Once the results of the upcoming tests are in, decisions will need to be made about where we go from here. Short of a HUGE miracle, E.'s fight against cancer will continue. Treatment may consist of more chemotherapy or even possibly surgery. (Radiation is no longer an option since he received his lifetime maximum.)
We were initially told that since E. was diagnosed as Stage IV, he was not a surgical candidate and would be treated with chemotherapy and radiation instead. After the completion of treatment, he could be re-staged and on a long-shot, if he were re-staged as a Stage III or lower, he could possibly become a candidate for surgery. We had heard conflicting reports if Esophageal Cancer was even curable, but the general consensus was that the only hope for "curing" this beast was surgery.
As you may remember, we met with a throacic surgeon and oncology team at UC Davis, who made it pretty clear that surgery was not an option for E. As we did further research, we discovered that while it was UC Davis' position not to operate on Stage IV cancer patients, that was not a universal protocol. Other hospitals and/or surgeons do in fact perform surgery on patients such as E.
The search to find good cancer hospitals is not an easy one. It is not as simple as googling "good cancer hospital." Hosptials are defined as "good" for various reasons, including treatments, physicians, research, surgeries, funding, education, etc; and a good hospital for breast cancer might not necessarily mean a good hospital for esophageal cancer. While the National Cancer Institute has a list of "designated cancer centers," there is nothing out there that breaks it down more specifically. For E., we wanted to find a good hospital with a good physician to possibly perform a good surgery . . . all in regards to esophageal cancer. Hmmm.
Basically we read a lot about and talked to other esophageal cancer patients. If money and distance were not an option, E. would undoubtedly be headed to Sloan Kettering in New York. To keep things more west coast, we heard good things from other esophageal cancer patients about the following . . . City of Hope in Duarte, California (near Los Angeles), Mayo Clinic in Scottsdale, Arizona (near Phoenix) and MD Anderson in Houston, Texas.
So, to keep some options open, we already began the referral process to these three facilities. We anticipate that we will soon need to make the decision to travel to one of these places. A consultation isn't the only thing under consideration. We need to think about down the road some as well . . . if E. does have surgery. The three mosts common types of surgery for esophageal cancer are the Ivor Lewis procedure, a Trans hiatal esophogectomy (THE) and a trans throacic esophogectomy (TTE) . . . all of which are a MAJOR ordeal. These surgeries are HUGE . . . long operating times, weeks of recovery in the hospital, weeks of recovery at "home" (before travel is allowed), more recovery at home, the potential for complications, etc.
As you can see, it is not just the matter of airfare to one of these locations. We need to research potential temporary housing options . . . for Peanut and I while E. is in the hospital and then somewhere for all three of us while E. recuperates until he can travel. A hotel stay for any lengthy period of time could prove to be costly. Staying with friends (or friends of friends) while it is just Peanut and I would probably be feasible, but less so once E. is discharged from the hospital . . . I don't imagine he'd be too comfortable in someone else's home. There was once mention of the possibility of a condo being loaned to us, but I don't know where that stands.
So, as much as I'm thinking aloud here, I'm also looking to pick your brains. What have you heard about these facilities? What do you know about these cities? What ideas might you have about housing options? What are your suggestions about transportation while there? Anything else you think we should be taking into consideration?
Again, the hospitals/locations currently being considered are:
* City of Hope near Los Angeles, California
* Mayo Clinic near Phoenix, Arizona
* MD Anderson in Houston, Texas
As always, your input, suggestions and ideas would be welcomed.
We were initially told that since E. was diagnosed as Stage IV, he was not a surgical candidate and would be treated with chemotherapy and radiation instead. After the completion of treatment, he could be re-staged and on a long-shot, if he were re-staged as a Stage III or lower, he could possibly become a candidate for surgery. We had heard conflicting reports if Esophageal Cancer was even curable, but the general consensus was that the only hope for "curing" this beast was surgery.
As you may remember, we met with a throacic surgeon and oncology team at UC Davis, who made it pretty clear that surgery was not an option for E. As we did further research, we discovered that while it was UC Davis' position not to operate on Stage IV cancer patients, that was not a universal protocol. Other hospitals and/or surgeons do in fact perform surgery on patients such as E.
The search to find good cancer hospitals is not an easy one. It is not as simple as googling "good cancer hospital." Hosptials are defined as "good" for various reasons, including treatments, physicians, research, surgeries, funding, education, etc; and a good hospital for breast cancer might not necessarily mean a good hospital for esophageal cancer. While the National Cancer Institute has a list of "designated cancer centers," there is nothing out there that breaks it down more specifically. For E., we wanted to find a good hospital with a good physician to possibly perform a good surgery . . . all in regards to esophageal cancer. Hmmm.
Basically we read a lot about and talked to other esophageal cancer patients. If money and distance were not an option, E. would undoubtedly be headed to Sloan Kettering in New York. To keep things more west coast, we heard good things from other esophageal cancer patients about the following . . . City of Hope in Duarte, California (near Los Angeles), Mayo Clinic in Scottsdale, Arizona (near Phoenix) and MD Anderson in Houston, Texas.
So, to keep some options open, we already began the referral process to these three facilities. We anticipate that we will soon need to make the decision to travel to one of these places. A consultation isn't the only thing under consideration. We need to think about down the road some as well . . . if E. does have surgery. The three mosts common types of surgery for esophageal cancer are the Ivor Lewis procedure, a Trans hiatal esophogectomy (THE) and a trans throacic esophogectomy (TTE) . . . all of which are a MAJOR ordeal. These surgeries are HUGE . . . long operating times, weeks of recovery in the hospital, weeks of recovery at "home" (before travel is allowed), more recovery at home, the potential for complications, etc.
As you can see, it is not just the matter of airfare to one of these locations. We need to research potential temporary housing options . . . for Peanut and I while E. is in the hospital and then somewhere for all three of us while E. recuperates until he can travel. A hotel stay for any lengthy period of time could prove to be costly. Staying with friends (or friends of friends) while it is just Peanut and I would probably be feasible, but less so once E. is discharged from the hospital . . . I don't imagine he'd be too comfortable in someone else's home. There was once mention of the possibility of a condo being loaned to us, but I don't know where that stands.
So, as much as I'm thinking aloud here, I'm also looking to pick your brains. What have you heard about these facilities? What do you know about these cities? What ideas might you have about housing options? What are your suggestions about transportation while there? Anything else you think we should be taking into consideration?
Again, the hospitals/locations currently being considered are:
* City of Hope near Los Angeles, California
* Mayo Clinic near Phoenix, Arizona
* MD Anderson in Houston, Texas
As always, your input, suggestions and ideas would be welcomed.
Prayers needed
E.'s PET scan is scheduled for May 21st.
What is a PET scan anyways? (The following information was obtained from the Cleveland Clinic.)
A PET (Positron Emission Tomography) scan is a unique type of imaging test that helps doctors see how the organs and tissues inside the body are actually functioning.
The test involves injecting a very small dose of a radioactive chemical, called a radiotracer, into a vein of the arm. The tracer travels through the body and is absorbed by the organs and tissues being studied. While lying down on a flat examination table, it is moved into the center of a PET scanner—a doughnut-like shaped machine. This machine detects and records the energy given off by the tracer substance and, with the aid of a computer, this energy is converted into three-dimensional pictures. A physician can then look at cross-sectional images of the body organ from any angle in order to detect any functional problems or "hot spots."
A PET scan is different from other imaging tests like a CT scan or a magnetic resonance imaging (MRI) because a PET scan reveals the cellular level metabolic changes occurring in an organ or tissue. This is important and unique because disease processes often begin with functional changes at the cellular level and cancer consists of rapidly dividing cells. A PET scan can often detect these very early changes whereas a CT or MRI detect changes a little later as the disease begins to cause changes in the structure of organs or tissues.
E.'s Endoscopic Ultrasound (EUS) is scheduled for May 22nd.
What is an EUS again? (The following information was obtained from the UT Medical Center.)
As you may recall, E. had his first EUS on February 16th which determined the stage of his cancer. An Endoscopic Ultrasound (EUS) combines endoscopy and ultrasound in order to obtain images and information about the digestive tract and the surrounding tissue and organs. Endoscopy refers to the procedure of inserting a long flexible tube via the mouth or the rectum to visualize the digestive tract, whereas ultrasound uses high-frequency sound waves to produce images of the organs and structures inside the body. Traditional ultrasound sends sound waves to the organ(s) and back with a transducer placed on the skin overlying the organ(s) of interest. Images obtained by traditional ultrasound are not always of high quality. In an EUS, a small ultrasound transducer is installed on the tip of the endoscope. By inserting the endoscope into the upper or the lower digestive tract, high quality ultrasound images of the organs inside the body can be obtained.
Because of the proximity of the EUS transducer to the organ(s) of interest, the images obtained are frequently more accurate and more detailed than the ones obtained by traditional ultrasound. The EUS also can provide information regarding the depth of penetration of the cancer and spread of cancer to adjacent tissues and lymph nodes. Additionally, the EUS can obtain tissue samples by passing a special needle, under ultrasound guidance, into enlarged lymph nodes or tumors. The tissue or cells obtained by the needle can be examined by a pathologist under a microscope.
The results of these tests will tell us how effective the chemotherapy and radiation treatments were. It will also help determine any future treatment options, including the possibility of surgery. Of course, the results of both of these tests won't be available until the following week.
Pray for good news. Pray for a miracle. Pray for E.
What is a PET scan anyways? (The following information was obtained from the Cleveland Clinic.)
A PET (Positron Emission Tomography) scan is a unique type of imaging test that helps doctors see how the organs and tissues inside the body are actually functioning.
The test involves injecting a very small dose of a radioactive chemical, called a radiotracer, into a vein of the arm. The tracer travels through the body and is absorbed by the organs and tissues being studied. While lying down on a flat examination table, it is moved into the center of a PET scanner—a doughnut-like shaped machine. This machine detects and records the energy given off by the tracer substance and, with the aid of a computer, this energy is converted into three-dimensional pictures. A physician can then look at cross-sectional images of the body organ from any angle in order to detect any functional problems or "hot spots."
A PET scan is different from other imaging tests like a CT scan or a magnetic resonance imaging (MRI) because a PET scan reveals the cellular level metabolic changes occurring in an organ or tissue. This is important and unique because disease processes often begin with functional changes at the cellular level and cancer consists of rapidly dividing cells. A PET scan can often detect these very early changes whereas a CT or MRI detect changes a little later as the disease begins to cause changes in the structure of organs or tissues.
E.'s Endoscopic Ultrasound (EUS) is scheduled for May 22nd.
What is an EUS again? (The following information was obtained from the UT Medical Center.)
As you may recall, E. had his first EUS on February 16th which determined the stage of his cancer. An Endoscopic Ultrasound (EUS) combines endoscopy and ultrasound in order to obtain images and information about the digestive tract and the surrounding tissue and organs. Endoscopy refers to the procedure of inserting a long flexible tube via the mouth or the rectum to visualize the digestive tract, whereas ultrasound uses high-frequency sound waves to produce images of the organs and structures inside the body. Traditional ultrasound sends sound waves to the organ(s) and back with a transducer placed on the skin overlying the organ(s) of interest. Images obtained by traditional ultrasound are not always of high quality. In an EUS, a small ultrasound transducer is installed on the tip of the endoscope. By inserting the endoscope into the upper or the lower digestive tract, high quality ultrasound images of the organs inside the body can be obtained.
Because of the proximity of the EUS transducer to the organ(s) of interest, the images obtained are frequently more accurate and more detailed than the ones obtained by traditional ultrasound. The EUS also can provide information regarding the depth of penetration of the cancer and spread of cancer to adjacent tissues and lymph nodes. Additionally, the EUS can obtain tissue samples by passing a special needle, under ultrasound guidance, into enlarged lymph nodes or tumors. The tissue or cells obtained by the needle can be examined by a pathologist under a microscope.
The results of these tests will tell us how effective the chemotherapy and radiation treatments were. It will also help determine any future treatment options, including the possibility of surgery. Of course, the results of both of these tests won't be available until the following week.
Pray for good news. Pray for a miracle. Pray for E.
Friday, May 1, 2009
Blood Clot
There haven't been any updated posts because there hasn't really been anything new to share. The two weeks following the completion of chemotherapy and radiation were ROUGH on E. The doctors warned us that he'd feel the worst when treatment was over and they were right. This last week though has been much better. Whew! He has been eating a bit more and sleeping sounder. His energy level is increasing and he just looks generally better.
His weight had gone down to 152 lbs, but he is slowly gaining a little bit of weight back. His white blood count (for fighting infections) had bottomed out at 2.0 and his platelet count (blood clotting) hit a low for him of 72. The doctors advised him to stay away from large crowds and wash his hands regularly to limit his exposure to germs since he would be extra susceptible. They also advised him to not participate in any contact sports or other activities where he may have been injured. Should he become injured or have a bleeding wound, his blood may not clot like it should due to his low platelet count and he should seek medical attention immediately.
So . . . low platelet count means his blood isn't clotting normally. Easy enough to follow, right? Then, how the heck did he wind up with a blood clot?!? At one of the follow-up doctor appointments this week, E. mentioned that his arm was still tender from where his PICC line had been inserted. So today we were off for an ultrasound which confirmed that E. does in fact have a blood clot in his arm. Thankfully, it is a superficial blood clot (Superficial Thrombophlebitis) and NOT a DVT (Deep Vein Thrombosis). It should resolve itself, but in the meantime, E. is to take some over-the-counter anti-inflammatories and alternate warm and cold compresses on the area to help with the discomfort.
Other than that, E. is just working on healing. He has weekly labs, as well as a couple of follow-up doctor appointments each week. His body needs to heal sufficiently from all the chemotherapy and radiation before new scans can be done to determine how successful the treatment was. It is anticipated that a PET scan and another Endoscopic Ultrasound will be performed the last week of May or the first week of June. From there, the next plan of attack can be determined. We've completed self-referrals to three other well-known cancer hospitals . . . the Mayo Clinic in Arizona, MD Anderson in Texas and City of Hope in California. Once all the new information is in, E. can decide how he wants to pursue it. We just wanted to make sure to keep our options open.
Also, to quell a rumor about his retirement . . . E. did meet with the PERS retirement folks to discuss retirement options. Once again, this was just to make sure he knew his options. A medical/disability retirement may be an option eventually, depending on how things progress and if surgery happens or not. A regular retirement may also be an option eventually, but with the percentage offered and the penalties due to his age, that is not feasible at this point.
E. was able to have a "Boys' Night Out" and went to an Aces Baseball game with a few of his buddies. It was so nice for him to be able to get out, and even sip on a couple of beers. I know several people have mentioned that they have been hesitant to call or visit because they weren't sure if E. felt up to it. Though he still tires easily and isn't the wild party animal he once was, some socialization would do him good. He's too nice to say it to me, but he's got to be sick of me as his only adult company. Anyways, the phone line and the door is open.
S.
His weight had gone down to 152 lbs, but he is slowly gaining a little bit of weight back. His white blood count (for fighting infections) had bottomed out at 2.0 and his platelet count (blood clotting) hit a low for him of 72. The doctors advised him to stay away from large crowds and wash his hands regularly to limit his exposure to germs since he would be extra susceptible. They also advised him to not participate in any contact sports or other activities where he may have been injured. Should he become injured or have a bleeding wound, his blood may not clot like it should due to his low platelet count and he should seek medical attention immediately.
So . . . low platelet count means his blood isn't clotting normally. Easy enough to follow, right? Then, how the heck did he wind up with a blood clot?!? At one of the follow-up doctor appointments this week, E. mentioned that his arm was still tender from where his PICC line had been inserted. So today we were off for an ultrasound which confirmed that E. does in fact have a blood clot in his arm. Thankfully, it is a superficial blood clot (Superficial Thrombophlebitis) and NOT a DVT (Deep Vein Thrombosis). It should resolve itself, but in the meantime, E. is to take some over-the-counter anti-inflammatories and alternate warm and cold compresses on the area to help with the discomfort.
Other than that, E. is just working on healing. He has weekly labs, as well as a couple of follow-up doctor appointments each week. His body needs to heal sufficiently from all the chemotherapy and radiation before new scans can be done to determine how successful the treatment was. It is anticipated that a PET scan and another Endoscopic Ultrasound will be performed the last week of May or the first week of June. From there, the next plan of attack can be determined. We've completed self-referrals to three other well-known cancer hospitals . . . the Mayo Clinic in Arizona, MD Anderson in Texas and City of Hope in California. Once all the new information is in, E. can decide how he wants to pursue it. We just wanted to make sure to keep our options open.
Also, to quell a rumor about his retirement . . . E. did meet with the PERS retirement folks to discuss retirement options. Once again, this was just to make sure he knew his options. A medical/disability retirement may be an option eventually, depending on how things progress and if surgery happens or not. A regular retirement may also be an option eventually, but with the percentage offered and the penalties due to his age, that is not feasible at this point.
E. was able to have a "Boys' Night Out" and went to an Aces Baseball game with a few of his buddies. It was so nice for him to be able to get out, and even sip on a couple of beers. I know several people have mentioned that they have been hesitant to call or visit because they weren't sure if E. felt up to it. Though he still tires easily and isn't the wild party animal he once was, some socialization would do him good. He's too nice to say it to me, but he's got to be sick of me as his only adult company. Anyways, the phone line and the door is open.
S.
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