for Pat Adair, and the people who love her...

Our beloved Pat got some shocking news recently, and we're off and running on a mysterious medical adventure. Not an adventure we would have picked, but we're off just the same... (If you're new to the blog, start here.)

Wednesday, January 2, 2008

Day 2: Uncertainty abounds

This is Dave again. I spent the day with Mom at John Muir Hospital in Walnut Creek, where I'm happy to report that the entire staff is cheery and helpful. Mom's in the oncology (cancer) ward, which might account for the professionalism and good care. There's a section of the hallway with touching plaques donated by families who've lost a loved one, all thanking the staff for their efforts.

Patio had a solid night's sleep for the first time in quite a while, and is in good spirits, in spite of how reasonable it would be to be despondent.

We met with two doctors today, one who is a gastroenterologist, and one who is the oncologist. Dr. Lane, gastro-guy, recommends a procedure that will be carried out in the afternoon of Thursday, Jan. 3rd. It's called an ERCP (Endoscopic Retrograde Cholangiopancreatography); five bonus points for you if you can pronounce it. They'll put Mom under anesthesia (less than you would have for surgery) and insert a flexible fiber cable with a camera on the end of it, through her stomach and into the duodenum, the first "pipe" leaving the stomach. (I'm figuring this out as I go along, so forgive me if I make mistakes - or correct me in the comments.) The device also has the ability to make incisions, perform biopsies and cauterize incisions. There are two primary goals: 1) insert a tube that will drain the bile that is not currently draining, and 2) take a biopsy (of the liver or pancreas?) to determine what type of cancer Mom has.

As the doctor says, if all goes well, both of these will be successful, her skin will return to its normal color, and a (likely) chemotherapy regimen can be determined. If the biopsy is unsuccessful, a needle biopsy from outside the stomach will be necessary (probably on another day.) And if the drain tube doesn't work, it's possible that an external tube will be required. Let's hope that doesn't happen, because you end up with a bag for the bile waste on the outside of your body.

Mom's oncologist, the lyrically named Dr. Jewel Johl, explained that the chemo regimen is determined largely by the type of cancer, and you can't know that until you have a biopsy. At this point, he's quite certain that there is cancer, but can't know what type. He didn't want to speculate about the many possibilities, but did say that it takes 48-72 hours after extracting the biopsy to get the result, and maybe two weeks after that the chemotherapy can begin. Just to complicate things, he also said that the hip pain that Mom's been suffering from is potentially related to the cancer. So the shot that she was so looking forward to for the relief it might provide, will have to wait until after a bone scan. And it's difficult to distinguish cancer from arthritis in a bone scan. Of course. Otherwise it wouldn't be so difficult.

Basically, there are a huge number of unknowns about what may happen even in the next week or two, much less what will come over the longer term. We've all seen how strong the desire is for some kind of certainty: what kind of cancer is this, when does the treatment start, and how long does it last. But the nature of this disease, and indeed life itself, doesn't follow our notions of how it ought to be. But Mom has been so strong and positive in the face of it. She's not pretending like it's not happening, or avoiding looking at it. She's looking it in the face, acknowledging that it stinks, and says that all she can do is take the next step, and face it as it comes.

If you click on the "comments" link below, you can add your own comment, which we'll be sure to get to Mom.



At January 3, 2008 11:33 AM , Anonymous Anonymous said...

Oh, Pat! What can I say, except that I am thinking of you constantly and hoping for the very best outcome. I send you much love and a giant hug.

Dave, you write beautifully about this horrible news, with such clarity and honesty. Your Mama raised a loving and talented boy!

Love, Whitney

At January 3, 2008 1:21 PM , Anonymous Julie said...

Hey All!
This sure is great to have this blog. You are getting sooo much info and sooo many people requesting updates, this really is the way to go. Thanks so much for being so considerate of all of us who love Aunt Pat. Look forward to the next update.

At January 3, 2008 5:04 PM , Anonymous Anonymous said...

I just got off the phone with Mike. The surgeon was able to successfully insert the tube to drain the bile! A piece of tissue was taken (hopefully enough) for the biopsy. Pat should be awake in a couple of hours. I have the flu so I haven't been able to see Pat. Courtney went today and has kept the boys company. Dave will update the blog tonight with more details. Thank you so much for your support.


At January 3, 2008 6:29 PM , Anonymous Anonymous said...

Dear Pat, Dave, Mike and all the Adairs,

Dear Dave, Thank you so much for this blog. Your information has helped us to sort out this upsetting situation and we really appreciate your generosity in making it available to us. We are so grateful to know that you and Mike and his family have been with your Mom this week.

Dear Pat, This whole thing stinks but we want you to know that we love you and you are in our thoughts and prayers always. We put your name on the prayer roll at the Oakland Temple last night which means that a whole lot of people are praying for you. Claude says, "Rats, now he has to go to the show with me until you get well, so get well quick." We look forward to being able to visit you soon. Hugs and kisses, Myrth, Claude and Kim

At January 3, 2008 7:29 PM , Anonymous Anonymous said...

How great to have David who can keep us all up to date with out having to bother you, though I may have to call anyway. I wish words could take it all away, but I know that you are especially strong and will see this through. Cindy sends her love. You are in my prayers,
Love, Gladys

At January 3, 2008 9:15 PM , Anonymous Brooke said...

I know the sentence I'm about to write is going to make me sound completely lacking of any intelligence but I'm not quite sure how to say it any other way:
Grandma is the most strongest and most caringest amazingest incrediblest person in this whole wide world if I was her I would not have half her strength. She is had the BIGGEST obstacles in her life and somehow she goes over them like the average person does speed bumps on a road. The only complaints she makes are quiet, and all I can think about now that I'm back at home and we're not in Utah is what Grandma said both times she bought all of us a meal, "Of course I'll buy it, I have to to make sure you all still love me."
I don't understand why Grandma goes through all of this stuff.
I was talking to my best friend about what's going on and she said exactly what I was thinking, "Wow, why does your family go through all of these things yearly?"
With Bob, and Great Grandma, and Dad, and now Grandma (for the second round since breast cancer), it's crazy the obstacles we've been forced to overcome as a family. At first I felt as if we were burdened, unappreciated, that all bad things got dumped on us. Then, I transitioned into thinking maybe God and the universe was testing us, seeing how strong our bond as a family was to keep our foundation against the tough winds being thrown at us. But finally I decided it's because it's well known how amazingly close and strong of a family we are. Because not very many people can go through what everyone in our family has gone through and end the day thankful and grateful for every moment lived. I don't know many people who can deal with all of this. But besides that, Grandma I love you and I'm sorry I didn't want to talk to you I don't want you to hear me cry because I can't deal with seeing or hearing the ones I love in pain. I don't know if you remember but I couldn't even talk to Dad when he got out of surgery. but I love you to death and I know we can fight this because our family has dealt with this stuff before and we'll do it again. I love you times a million bazillion.


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