Waiting

May 24, 2013: Turned out to be a day full of mixed emotions.

Mom had her CT scan.  Pretty uneventful.  After fasting all morning though, she was hungry for a snack!  We headed to the little cafe at the clinic building and sat down for a bit before heading to the next appointment.

We met with Dr. Vickers, the surgeon who would do the Whipple procedure, as long as everything looked okay from the scan.  He came in all confident, skipped going over the CT results with us, and went straight to talking about the surgery.  We listened, our hopes getting higher that surgery was a 'go'.  When Dr. Vickers asked if we had any questions, the only one we came up with was "Does this mean the scan looks good and we are definitely headed to surgery?"  Oh.  The scan.  He pulled up the scan, showed us the abdominal and gastrointestinal areas saying "everything looks good".  We left feeling excited for the next step, which was confirming the date and setting up any pre-operative consultations that were needed.

Next stop, the oncologist's office to meet with a Physician's Assistant (PA) who works with Dr. Blaes', mom's oncologist.  We were running a few minutes late so found ourselves in a room at the clinic almost immediately.  Two PA's came into the room and introduced themselves.  Natalie and Tara; Natalie did most of the talking.  She asked how the appointment with Dr. Vickers went and we smiled.  Mom shared the news that we were headed to surgery in June.  We went over much of the same questions that we had encountered with Dr. Vickers; how was mom feeling, how did chemo go, any other issues...  A short physical exam was performed.  Then, the room got quiet.  Natalie seemed to be nervous.  I think we all knew something was going on and at that point I could feel a knot growing inside my stomach.

Natalie explained that although the radiologist had not yet officially turned in a reading of Mom's CT scan, she had pulled him aside and asked him to walk her through it so she could be confident when talking to us.  The radiologist expressed some concern about "nodules" seen in the lungs.  Some of these areas had been present on the first scans but all were in agreement that they were nothing to worry about; apparently when you live in a damp place like Minnesota you are pretty likely to have some fungal spots in your lungs that will never affect you.  Some of those areas were more prominent now, almost as if they had grown and become more solid.  Some, two in particular, looked suspicious.  There was speculation that the cancer had spread, despite the chemotherapy.  Natalie explained that the spots could be inflammation or an infection starting.  She continued to talk although I am not sure how much any of us really heard her.  Something about a 2-week course of strong antibiotics and doing another CT to see if the lung spots got any better.

We must have all looked a bit dazed.  Tara, the other PA, said that Dr. Blaes was in a meeting but that she was aware of the news being delivered and had offered to see us immediately following her meeting and did we want to wait.  We all agreed; We needed to talk to Dr. Blaes and understand what was happening; We waited.

We all sat in silence for a while.  Trying to take this news and digest it.  Kim questioned the idea of antibiotics; what would that really do?  Wouldn't it be better to just find out what was going on in Mom's lungs?  We waited.

Tara stopped in and told us Dr. Blaes would be right with us.  That she was actually meeting with someone from the Thoracic department so that she could understand all our options before talking with us.  We waited.

Dr. Blaes came in, apologizing for the wait and for the fact that we had been allowed to get our hopes up only to have some pretty disheartening news delivered.  She addressed mom directly, asking her how she was holding up.  My eyes started to well up as mom explained perfectly how I think we were all feeling; Shocked and overwhelmed.

Dr. Blaes went through the CT with us again, focusing on the spots seen in the lungs, calling out the two areas of concern.  She proceeded to tell us the same thing that Natalie said about inflammation or infection; something about how antibiotics might give us some clarity.  Then she presented another option.  Biopsy the area of the lung and just know for sure what we were dealing with.  We agreed the biopsy was our best option.  We needed confirmation and clarity and this would be the fastest way to get it. 

Dr. Blaes said she had already talked with the thoracic surgeon that could do the procedure.  Dr. Podgaetz.  It would be a laparoscopic procedure where they would remove a "wedge" of the lung, one of the areas where a suspicious spot was seen on the CT.  They would then be able to biopsy that spot and have the pathology results back within a week from surgery.  If it wasn't cancer, we would stay on schedule for the Whipple procedure with Dr. Vickers on June 18th.  We would proceed with the knowledge that the lung spots were benign.

What if it was cancer?  It was the question none of us wanted to ask but all of us needed to know the answer to.  If the cancer had spread to Mom's lungs then the chemo had not worked as we had hoped.  She would no longer be a surgical candidate but would continue on chemo, likely a different regimen, to keep her feeling good.

Another flurry of appointments were set up.
Tuesday, May 28, 1:00pm - Consulation with Dr. Podgaetz, Thoracic surgeon at the U of MN
Mom will get a chance to meet the surgeon and talk with him about the procedure and what to expect.

Monday, June 3, time TBD - Thoracic "Wedge" procedure at the U of MN
Mom will have the procedure and the sample will be biopsied.  It is typically a one-night stay in the hospital.

End of the week of June 3, date/time TBD - Meet with Dr. Blaes to discuss the pathology results
We left in a daze and I can't remember if we were supposed to schedule this or if Dr. Blaes' nurse would be calling... I suppose I should make sure we follow-up on that.  Either way, we should know more by the second week in June.

Keep those positive thoughts and prayers coming.  We need some good news in the next couple weeks.  Until then, we wait.