Thursday, October 6, 2011

Caught in the N.E.T.

The one that didn't get away. See you soon Steve.
  When you are caught in The Net you look around to see who else is there. Only a few of us. It's quite a rare cancer. Steve was here, for a while anyway. We all get the five year 'use by date'. We all end up under the microscope. Researchers and doctors gather around, filling the places that former friends and colleagues vacated with distasteful alacrity. We must learn a new language. Abdo CT, MRI, EUS, Chromogranin A (CgA).
Oxycontin, Metformin et al.
Old words take on new and sinister meanings. A prognosis can be 'guarded' or 'poor'. I hope someone is guarding the poor. With time off work and medical bills that is where I'll end up. Still, better in Australia than the U.S.

Fish finder? Death Ray?
It's just heartburn and stomach ache (yeah right...) In goes the cannula and sedation, down goes the camera, a bus and two trucks. Out comes the FNA biopsy. The boys have a look. Not happy.
Dr Crispin Corte (EUS wiz) says to me 'It's a bit more serious than that, but don't book a holiday just yet!'.
Dr. Gavin Barr (The Gastroenterologist)
thinks this is funny. It was funny, typical Aussie irreverence. I was just a bit pre-occupied is all.
It was a bit more serious. When fifty milligrams of morphine and 5 micrograms of fentanyl in the ambulance wont touch the pain, it's a bit more than a stomach ache.
Acute pancreatitis secondary to chronic pancreatitis.

"Is it fatal?" I ask. "Well they're all fatal - eventually" quips Gavin with a slight smile as he tilts his head forward and peers over the top of his specs. "... but if you've got to get one, this is the one to get".
"Well, That's a relief!" I think sarcastically, I feel so lucky I could just vomit. Tell that to Steve Jobs.

Plan 'A'  -  E.B.M
Note blue dye in center field.
So we hatch a plan. Crispin and Gavin meet with their cronies and decide Cris will mark the tumour with blue dye using an endoscope at Concord  and Dr. David Martin will burn the mother out laparoscopically at RPA.

Dr. David Martin
So one of my concerns is waking up on the table. When Cris was doing the endoscopy work, I woke up, tapping the canula in my wrist and yelling (as much as you can with a throat full of rubber pipes!). "Mate, your drugs are no good" I said "I can get better drugs up the pub!" So I relate this to the Anesthesiologist. "I don't want to wake up!" I say. "What! Not even after the operation?" he quips. "Eh, yeah, afterwards, that would be alright I suppose." I concede stupidly.

Burn baby burn.
David Martin skips in happily, "We all ready to go? Good, don't worry Pete, haven't lost one yet". Liar! I think to myself but I'm too worried about the stuff the anesthetist is playing with. "Is that a cannula" I ask goggling at what looks like an air-con duct. "Don't worry, we'll give you a local first' she grins back. "Well at least it's not an arterial line." I moan. "That's next" she says. I mumble something like " crrrap". Art-lines really, really hurt. Another local so it's not to bad. "I have heart trouble and undergo heaps of surgery" she says showing me her wrist which has more spots and bruises than a road-side pear. I feel like a wimp.

PCA Machine.
It all goes to plan, for them. Personally, I wake up feeling like shit. I have the ICU nurse telling me to sleep on my side or risk pneumonia, an intern adjusting my gown so that my package is not displayed to the whole ICU, and the anesthetist telling me to press the PCA button more often! Press Press, Press. The annoyances fade. Zzzzzz

Bill. K. The laughing Chinaman in the bed next to me, had the nasty version - Distal pancreatectomy and splenectomy. Full laparotomy, bloody big cut. Bill has chemo every Saturday, I'll join him with some good coffee and 'hold his hand' so to speak. We'll put aside the fear and insecurity, drink our coffee, talk shit and play with our iPhones.

Anyway, Eventually, Here I sit, updating the blog, but the Damoclean sword is still dangling over my head. Steve lasted six years. Magnificent effort! I can hardly not try. People say he was an inspiration, they don't know the half of it. He put up with way, way more than I did!

Pancreatic Tumour guys have to stick together to the bitter end.
Vale Steve Jobs (Legend!) 1955 - 2011
We'll Catch up shortly Steve.
Thanks for all the cool stuff!

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