The Port, Robert Wood Johnson and Happy Birthday

Yesterday Karen's "port-a-cath" or port was "installed". This is a small rubber disc with a few tubes attached. The whole thing goes under your skin around your collar bone on the right side. When a nurse needs to give you a chemo treatment or take blood, they simply draw from the disc, thus saving wear and tear on your veins. Karen took it like a champ.

Today we met with doctors from Robert Wood Johnson. Overall they were consistent with what we'd heard from Overlook hospital. The folks in the waiting room were all complaining about being kept waiting and called in for unnecessary reasons, despite having appointments setup in the very near future. One 77 year old was asked to wait 40mins to take some blood when she'll be back next week for chemo. Why they couldn't wait until next week was beyond her. I got the feeling that this was not the place for us. Karen felt the same way. I have no doubt in the knowledge of the doctors but the bedside manner and level of care was not on par with what we've seen closer to home. We will likely return here for surgery though.

Lastly, today is Karen's birthday! Happy birthday sweetheart.

The First Oncologist

We met with our first oncologist, Doctor Dan Moriarity today in Summit Overlook hospital. They are pretty good reputation-wise and closer than Robert Wood. We'll use RW for a second opinion but we were encouraged by the consultation this afternoon. It's about 20mins from our house if you race. 30mins if you take it easy. He's a nice guy, soft spoken but calm with easy demeanour.

Basically he's scheduling a PET scan for sometime soon but starting treatment in the mean-time.
A port will be inserted next Tuesday the 8th of May. This is a rubber-plug designed to make the drugs easier on your veins. It sits under the skin near your collar bone.

Then starting 2 months of chemo, with Avastin and 5-FU administered with a take-home pump. Chemo will be every two weeks starting on the 14th of May.

After a bunch of research on the web I have learned this is the standard chemo protocol for colon cancer it seems regardless of the stage. I've also heard that this is an "aggressive" treatment of chemo. The Avastin alone costs $10,000 per treatment. One person has estimated a single chemo appointment to run into $14,000 and my wife will receive them for the next 2 months. Thank God for insurance.

I did record everything with my MP3 player and I'll review everything tonight. I'm also starting to believe the Chemo will be the same at Robert Wood Johnson so why go out of your way to get to a doctor that's further away??? Overlook will be far more convenient travel-wise. Let's see what the 2nd opinion reveals. Definitely if surgery is considered in a few months we'll go to RobertWood as I think they have the best surgeons.

After two months they will re-scan and expect everything to shrink and shrivel away into nothing. That's what I'm visualizing in my spare moments.

The First Colonoscopy

Yesterday (May 2nd) my wife had a colonoscopy. The found a small tumor about 30cm into her colon. All other parts of the colon are within normal limits. The rectum is normal (thank God). So this was a good outcome. The tumor is not the size of a bowling ball or anything. It's about half the diameter of her colon. I guess she just was unlucky that it grew so quickly through the wall and went to the liver. They biopsied the mass and marked it with dye.

Last night she had a fever of 101.5 and after calling the doctor, took some tylenol and it went down.

Friday May 2nd: Colonoscopy Biopsy Results

Today we got results of the colon biopsy, confirmed the mets in the liver came from that tumor. No surprises but I'm learning to take everything that's not BAD news as good news. Also got Karen's CEA, it's 237. I was alarmed at this at first as normal ranges are between 0 and 10. From research on the web I am told the typical CEA for a stage IV patient is between 700 and 1000. The key is that this number goes down once chemo starts. It'll eventually reach 0 once all cancer is out of her body.

Make no mistake, this is the beginning of a long journey. We have a strong marriage and two beautiful children. I feel like we are really just starting our life as together as a family. We appreciate everyone's support thus far and recognize that we'll be leaning that much harder on people as time goes by.

Karen and I are up-beat and determined to kick some cancer ass.

The Biopsies

The First Biopsy

The biopsy was done on the 17th and we got the results on Thursday the 19th. They were negative meaning the biopsy indicated normal tissue. We were elated at this news but I should've known to ask more questions. With the wind in my sails I booked my wife and daughter on the first flight to Dallas the next day and they were able to attend the wedding. Unfortunately my daughter was sick the entire trip and in hindsight should've stayed home.

The Second Biopsy
The following Monday (the 23rd) a second biopsy was done to confirm the first result. The radiologist(Dr Sneickus) was frustrated that we had not gotten a result from the first procedure and it was then that we learned it was possible the first result was a false-negative. He promised the results to us the next day. Unfortunately these results took longer and we didn't get them until Friday the 27th of April over the phone from Dr Lipksy. He told us that Karen had cancer, that it was an advanced stage (stage IV) and that it would require chemo and most likely surgery. He could not give a prognosis until further tests were done. He recommended we hang up the phone, schedule a colonoscopy through his office and setup appointments with an oncologist, Doctor Moriarity in Overlook hospital, Summit.

The First Step

On April 07th, 2007 my wife went to the emergency room complaining of a pain in her right side. It had been there all week and she'd been scheduled for a CT scan that morning. Unfortunately she'd forgotten to drink the Berium and hence went to the emergency room in the hopes that they could expedite the diagnosis.

The Emergency Room
During the course of that Saturday she underwent a series of blood tests and scans including a CT scan and an MRI. The results indicated numerous large lesions in her right liver and left lobe. By 9pm I was on the way to the hospital. "Under Pressure" was playing on the radio. Whilst I was driving to the hospital my wife was told by the doctor on call (Dr. Michael Gould of Somerset Medical Center) that she had colon cancer which they believed had spread to her liver.

He should not have done that without a biopsy. No one can tell you you have cancer without a biopsy.

Monday saw a series of phone calls and triage. We scheduled an appointment with a GI doctor (Dr Marvin Lipsky) on Wednesday the 11th of April 2007. That appointment came and went. He was thorough, spoke very fast with little elocution. The diagnosis was that she did not have a blockage in her colon and that they would do a liver biopsy to determine whether the liver lesions are benign or malignant indicating cancer. The earliest we could schedule the biopsy for was the following Tuesday (17th). Karen's sister was getting married the following Saturday (21st) in Dallas and Karen would not be cleared to fly after the procedure. This was a difficult decision but the need to diagnose the problem outweighed the wedding and on Thursday the 12th we decided to cancel the trip to Dallas. That week I worked Tuesday, Thursday and Friday.