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Fri, Feb 5, 2016

10:11 a.m.

Mom and I arrived at the hospital at 8:35 a.m. Pap was resting. He said that he had a good night's rest.

For breakfast, he ate some pancake, bacon, spuds, and a doughnut. He's perched up in the recliner.

We are watching The Last Frontier, which is about living in Alaska.

I might go get the DVD player from the car. This new room has a desk where I can set it up.

Late morning

A therapist is having Dad do some arm exercises while seated in the chair. Another therapist will visit later for walking in the hallway if Dad is up for it.

Mid-day

Dad is back sitting up in the recliner after moving about in the room. He's drinking some coffee. We have the TV set to the Alaskan homesteading show, and the portable DVD player is playing a catfishing video with the volume down. We're setup.

6:03 p.m.

For Dad, yesterday was better than Wednesday, and today has been better than yesterday. Less blood clot pain today in the lung. He still occasionally takes a Vicodin.

He sat up in the recliner for most of the afternoon. He has been awake more today. He went for two walks on the floor this afternoon with therapists. His oxygen levels were fine. Now he can walk whenever he wants on the floor as long as Mom or I escort him.

When Dad was moved from a CCU room to a CV step down room last night, that meant no more being attached to wires and tubes. Obviously, that encourages mobility, and it makes resting more comfortable.

The stronger blood thinner medicine that Wheeling Park has given Dad this week is administered twice a day via a shot to the stomach. This will need to continue when Dad is home. Mom is already studying how it's done by watching YouTube videos. I will wait for the hospital lesson.

I have no idea yet when Dad will go home.

Dr Shinn has not visited yet.

Since Cabela's is only a few miles away, I bought two more fishing videos this afternoon.

9:35 p.m.

Dr. Shinn met with us from 6:55 to 7:50 p.m. on Friday.

Dad will need to receive blood thinner medicine via shots in the stomach for the rest of his life. This type of blood thinner medicine is the best, according to Dr. Shinn. The capsule types are apparently not strong enough. The cancer is able to clot the blood better than the capsule-based blood thinners can help dissolve the clots.

Cancer adds substances to the blood that can aid clotting. Dr. Shinn believes that the blood clots were indirectly caused by the cancer. In Dad's case, the clots were a symptom of the cancer's existence. And Dr. Shinn still believes that the tumor has been growing for one to two years. And again, Dad's pain last summer and/or early fall was probably due to the blood clots.

Nationwide, doctors and insurance companies have debated whether to conduct a scan for cancer on everyone who has a blood clot. A small percentage of patients with blood clots do have cancer.

It's standard procedure to conduct a genetic test on someone who has blood clots in order to inform other family members. Those results will come from Pittsburgh in a couple weeks. But Dr. Shinn believes that Dad's blood clots were related to cancer and not a genetic issue that may exist with other family members.

The hospital will teach us how to administer the blood thinner medicine shots. The shots will be given twice a day. Mom and Dad can adjust to their schedule. Usually, people give themselves the shots between 7 and 10 am and then again between 7 and 10 pm.

Since Dad will take a strong blood thinner medicine, he needs to eliminate the risk of cuts and falls. He already uses an electric razor. No snow shoveling.

Dr. Shinn wants Dad to walk more but not on a treadmill because of the fall risk. Dr. Shinn recommended that Dad exercise twice a day until tired but not exhausted. Mom, Dad, and I walked around the floor this evening, but Dad got tired after four minutes. He needs to build strength and endurance. But based upon the last couple days, I think Dad will get stronger over the next week. And since he will be home soon, that could help him get stronger.

Late evening

The green dots on the diagram indicated bone areas that are negatively affected by the cancer.

The biopsy results came back. It's Adenocarcinoma. He has stage 4 pancreatic cancer. It's located in an unusual part of the pancreas, but this is a common type of pancreatic cancer. It's not curable. It's controllable.

The plan. First, Dad needs to manage on his own (with Mom's help) at HOME for a week, and that means getting stronger, health-wise.

Dad will probably go home on either Sat, Feb 6 or Sun, Feb 7. The latest will be Mon, Feb 8.

Dr. Shinn will meet with Mom and Dad on Monday afternoon, Feb 8 at Dr. Shinn's clinic, which is located at Wheeling Park Hospital, a couple buildings over from where we are at now. This meeting will be more like an orientation or getting to know the who, what, when, and where about the treatment.

Dr. Shinn will implement an aggressive treatment plan that is used nationwide. It's the most aggressive plan on the market. No experimental drugs. Wheeling Park Hospital can not administer experimental drugs. Dr. Shinn's treatment is common for this type of cancer.

The minimum goals are to prevent anything new from forming and to prohibit the current tumor from growing larger. The best goal would be for the tumor to shrink, which can happen.

Treatment will be chemo. It will be a combo of three chemo drugs with a vitamin infusion. It's a basic recipe.

Dr. Shinn wants to start treatment on Mon, Feb 15. Dad will be at the clinic for six hours. It's an out-patient procedure. Then he will go home with a fanny pack-like contraption, which will be a pump that will be programmed to administer more chemo over the next two days.

It's a total of 48 hours of receiving chemo drugs every two weeks. And this will continue for four to six week at which time, Dr. Shinn will scan Dad to see how things are going, and a report card on his progress will be created.

But this treatment will never end for Dad. Everyday, he will take two blood thinner shots in the stomach. Every two weeks, he will endure a six-hour visit at the clinic for chemo, followed by about two days of chemo, mainly via the fanny pack. 2 days on, followed by 12 days off. After the 4th or 6th batch (every 8 to 12 weeks), he will get checked. And repeat.

When Dad is scanned for cancer, his chest will get checked for blood clots.

The first scan or report card should occur between mid-April and mid-May.

If the report card this spring is not up to goal, then Dad could try the Columbus hospital, which can offer experimental drugs.

Dad will receive the chemo either through a port that gets surgically installed, I think, in the upper chest or through a picc line, which has little tubes sticking out of him. Dad will start with the picc line for the first batch of 4 to 6 weeks, and then he will decide about the port after the first report card.

According to Dr. Shinn, the two common or primary side effects with this chemo treatment are fatigue and intolerance to cold. Dad will need to stay warm. He will need to avoid drinking cold fluids. Grabbing an ice cube could feel extremely painful. If it's arctic cold outside, then Dad will need to wear a ski mask if he goes out. Anything cold will feel much colder and possibly painful. But this cold intolerance only lasts for 48 hours, after or during each round of chemo.

Dr. Shinn advised Dad to journal his side effects. Hair loss will occur after four weeks. Dr. Shinn said nausea is usually not a problem because it's controlled. It's rare to have an allergic reaction to this recipe. Other possible side effects might be loose stools and tingling in the fingers and toes.

Short Term Tasks:

While I was down in the cafe typing up my notes, Mom gave Dad the blood thinner shot at 9:00 pm. No problems. Dad said that he didn't feel it. Mom will give the shot at 9:00 am on Saturday. And Dad received his pneumonia shot. We will bring Dad's clothes on Saturday in case he is discharged. If he goes home on Saturday, it will probably be in the afternoon.

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